Back to Insights and Updates for ProvidersJune 2023

Telehealth reimbursement for Tufts Health Direct members

Tufts Health Direct

As we announced in previous issues of Insights and Updates for Providers, Point32Health currently reimburses medical services provided via telehealth for our commercial Harvard Pilgrim Health Care and Tufts Health Plan members in Massachusetts, Rhode Island, and Maine at 80% of the in-person rate.

Effective for dates of service beginning Aug. 1, 2023, in an effort to align practices across products, we will apply the same reimbursement to telehealth services rendered to our Tufts Health Direct members. Services provided via telehealth to Tufts Health Direct members will be reimbursed at 80% of the in-person rate, with the exception of telehealth services provided by behavioral health providers, which will continue to pay at 100% of the in-person rate.

For additional information, please refer to the Tufts Health Plan Telehealth/Telemedicine Payment Policy, which we have updated to reflect the new reimbursement rate for Tufts Health Direct.

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