Point32Health has increased our reimbursement for behavioral health (BH) services provided via telehealth by non-BH providers for certain Massachusetts plans.
In support of guidelines and regulations from the Massachusetts Division of Insurance’s 211 CMR 52.16 (Access to Covered Services Through Telehealth), for Harvard Pilgrim and Tufts Health Plan Massachusetts fully insured Commercial plans and Tufts Health Direct, we will now reimburse behavioral health (BH) services provided via telehealth (submitted with a BH service code on a telehealth claim) at 100% of the in-person rate, whether they are provided by a BH or non-BH provider.
This represents an increase in reimbursement for non-BH providers as they were previously reimbursed at 80% of the in-person rate; the reimbursement rate for BH providers remains unchanged at 100%.
As a reminder, medical services provided via telehealth to our Commercial Massachusetts and Maine members will continue to be reimbursed at 80% of the in-person rate. For Rhode Island Commercial members, medical services provided by telehealth are reimbursed at 80% of the in-person rate, with the exception of telehealth services provided by in-network registered dietician nutritionists and PCPs who are reimbursed at 100% of the in-person rate. Medical services provided via telehealth to members of our Commercial New Hampshire plans reimburse at 100% of the in-person rate.
For additional information, please refer to the Tufts Health Plan and Harvard Pilgrim Telehealth/Telemedicine Payment Policies.
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