Point32Health covers medically necessary home- and community-based services (HCBS), including adult day health, adult foster care, and personal care services, in accordance with members’ benefits and applicable state regulations.
We’ve developed a payment policy for Tufts Health Plan Senior Care Options (SCO), effective for dates of service beginning Oct. 1, 2024 for the review of HCBS and to outline referral/authorization/notification requirements, billing instructions, and coding. Please be aware that as of that date, Point32Health will deny any claim lines submitted for SCO members that do not match the authorized number of days and level of care.
For complete information, please refer to the Home- and Community-Based Services (HCBS) Payment Policy.
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