ProviderMatters

Payment Policy Updates (May 2026)

Posted on May 1, 2026

Health New England is committed to reviewing our internal procedures and defining coverage and billing guidelines with applicable laws and industry standards to ensure our policies are appropriate. To access payment policies, please visit healthnewengland.org/Providers/Resources.

If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension 5000. A representative is available Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m.

The following payment policies have been updated:

Line-Level Billing Effective July 2026, All LOBs
  • New Policy – Outlines how we accept line by line billing and rolled-up charges are not reimbursable
Outpatient Psychotherapy

 

 Effective July 2026, All LOBs
  • New Policy – Outlines what we do today with additional guidance for psychotherapy codes billed with high-level E&M
Evaluation and Management Effective July 2026, All LOBS
  • Annual Review, added additional guidance for psychotherapy codes billed with high-level E&M
Podiatry Effective May 2026, All LOBs
  • New Policy – Outlines what we do today and strengthening our Payment Policy Portfolio
Serious and Reportable Events Effective May 2026, All LOBs
  • Annual Review, no updates
Skilled Nursing Facility Effective May 2026, All LOBs
  • Annual Review, Aligned authorization requirements
Vaccines and Immunizations Effective May 2026, All LOBs
  • Annual Review, Aligned vaccine description language

 

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Categories: Provider Newsletter

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