Back to Insights and Updates for ProvidersMarch 2023

Reminder: Telehealth Reimbursed at Pre-Pandemic Rate

Harvard Pilgrim and Tufts Commercial

As a reminder, Point32Health resumed our pre-pandemic telehealth reimbursement practices for Harvard Pilgrim Health Care and Tufts Health Plan providers, in keeping with guidance provided by the states we serve, for dates of service beginning March 1, 2023.

Point32Health recognizes that telehealth is a valuable care delivery system that expands access to much-needed services for patients nationwide and has proven to be particularly advantageous amid the challenges presented by the COVID-19 pandemic. We support ongoing care delivered via telehealth and will continue to reimburse for these visits as follows.

Medical services provided via telehealth to our Commercial Massachusetts, Rhode Island, and Maine members (with the exceptions noted below) will be reimbursed at 80% of the in-person rate.

The following telehealth services will continue to pay at 100% of the in-person rate:

  • Telehealth services provided by behavioral health providers to all Commercial members in Massachusetts, Rhode Island, Maine, New Hampshire, and Connecticut
  • Medical services provided via telehealth members of our Commercial New Hampshire and Connecticut plans
  • Telehealth services provided by in-network registered dietician nutritionists and PCPs for members of our Rhode Island Commercial plans

For additional information, please refer to the Harvard Pilgrim Health Care and Tufts Health Plan Telehealth/Telemedicine Payment Policies.

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