Harvard Pilgrim is updating our current standard outpatient facility fee schedule for acute rehabilitation hospitals, freestanding ambulatory surgery centers, and skilled nursing facilities, effective Jan. 1, 2027.

As of Nov. 1, 2026, you may request a preliminary sample fee schedule (which does not include the final edits for added and deleted codes) by contacting your contract manager. The final version of the same fee schedule will be available after Jan. 1.

Please keep the following considerations in mind regarding fee schedule updates for acute rehabilitation hospitals and ambulatory surgery centers, as well as skilled nursing facilities:

Acute Rehabilitation Hospitals and Ambulatory Surgery Centers:

Harvard Pilgrim is basing our fee schedule updates for acute rehabilitation hospitals and freestanding ambulatory surgery centers on the Centers for Medicare and Medicaid Services 2026 Ambulatory Payment Classification. For more information, please refer to our Outpatient Facility Fee Schedule Payment Policy.

Skilled Nursing Facilities:

The new standard outpatient fee schedule for skilled nursing facilities is limited to physical therapy, occupational therapy, and speech therapy. For more information, refer to the Commercial Skilled Nursing Facility Payment Policy.

Please contact your contract manager for any further questions you may have about these fee schedule updates.