Please refer to the chart below for information on new and updated Payment Policies. For details, access the policies listed below by visiting the Payment Policies section of our Point32Health provider website.
| Updates to Payment Policies | |||
| Payment Policy Title | Products Affected | Effective Date | Additional information |
Acupuncture
| Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct, Tufts Health Together, Tufts Health RITogether, Tufts Health One Care, Tufts Health Plan Senior Care Options, Tufts Medicare Preferred | 5/1/2026 | Minor administrative updates for accuracy and clarity.
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| Child and Adolescent Needs and Strengths (CANS) | Tufts Health Together | 5/1/2026 | Minor administrative updates for accuracy and clarity.
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| Newborn Care | Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct, Tufts Health Together, Tufts Health RITogether, Tufts Health One Care, Tufts Health Plan Senior Care Options, Tufts Medicare Preferred | 5/1/2026 | Minor administrative updates for accuracy and clarity.
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| Fraud, Waste, and Abuse | Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct, Tufts Health Together, Tufts Health RITogether, Tufts Health One Care, Tufts Health Plan Senior Care Options, Tufts Medicare Preferred | 5/1/2026 | Minor administrative updates for accuracy and clarity.
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| Urgent Care | Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct, Tufts Health Together, Tufts Health RITogether, Tufts Health One Care, Tufts Health Plan Senior Care Options, Tufts Medicare Preferred | 5/1/2026 | Minor administrative updates for accuracy and clarity.
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| Advanced Practice Provider (APP) | Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct, Tufts Health Together, Tufts Health RITogether, Tufts Health One Care, Tufts Health Plan Senior Care Options, Tufts Medicare Preferred | 5/1/2026 | Minor administrative updates for accuracy and clarity.
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| Clinical Trials | Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct, Tufts Health Together, Tufts Health RITogether, Tufts Health One Care, Tufts Health Plan Senior Care Options, Tufts Medicare Preferred | 5/1/2026 | Minor administrative updates for accuracy and clarity.
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| Audiology | Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct, Tufts Health Together, Tufts Health RITogether, Tufts Health One Care, Tufts Health Plan Senior Care Options, Tufts Medicare Preferred | 5/1/2026 | Minor administrative updates for accuracy and clarity.
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| Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services | Tufts Health Together, Tufts Health RITogether | 5/1/2026 | Minor administrative updates for accuracy and clarity. |
| Applied Behavioral Analysis (ABA) Services | Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct, Tufts Health Together, Tufts Health RITogether | 5/1/2026 | Minor administrative updates for accuracy and clarity.
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| All-Inclusive Clinic Visit (HCPCS Code T1015) | Tufts Health Direct, Tufts Health Together, Tufts Health One Care | 5/1/2026 | Administrative updates for accuracy and clarity, including removal of references to Tufts Health Plan Senior Care Options (SCO) Medi (a Medicaid-only product), which is no longer offered. |