While MassHealth is working to renew member eligibility, there may be several eligibility updates occurring at this time. In MassHealth All Provider Bulletin 372, MassHealth shared important reminders of billing responsibilities and billing for retroactively reinstated members.
Insights and Updates for Providers
In keeping with a bulletin from the Centers for Medicare and Medicaid Services, Point32Health now requires providers to report one of the following remote patient monitoring codes, as applicable, when billing for home health services administered via telehealth to our Tufts Health Medicare Preferred or Tufts Health Plan Senior Care Options members.
Integra will soon begin to assume management of the DMEPOS provider network for Point32Health’s Senior Products, starting on July 1, 2023 for Tufts Medicare Preferred and Tufts Health Plan Senior Care Options, and on Sept. 1, 2023 for Harvard Pilgrim Stride (HMO)(HMO-POS) Medicare Advantage.
Point32Health has updated our applicable Tufts Health Plan systems, as well as the Tufts Health Plan Evaluation and Management Professional Payment Policy, to reflect MassHealth guidance on coverage of provider-to-provider e-consults.
We’re offering some reminders and clarifying information on billing for telehealth services for Tufts Health Plan Senior Care Options, Tufts Health Together, and Tufts Health Unify members.
Effective for dates of service beginning Sept. 1, 2023, CPT code 99070 (supplies and materials provided by the physician or other qualified healthcare professional) will no longer be separately reimbursed for ambulatory surgical centers (ASCs).