ProviderMatters

Payment Policy Updates (August 2026)

Posted on July 30, 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:

Payment Policy Updates Effective Date Notes
Gastroenterology Services (PP066POL) – NEW October 2026
  • All Lines of Business
  • New Policy – Outlines what we do today and strengthening our Payment Policy Portfolio
Sexually Transmitted Infectious Testing (PP058POL) – NEW October 2026
  • Commercial and Medicare Only
  • New Policy – Outlines what we do today with coding limitations to strengthen our Payment Policy Portfolio
Audit Program (PP010POL) – REVIEWED August 2026
  • All Lines of Business
  • Annual Review – Aligned language to strengthen policy
Newborn and Neonatal Intensive Care (PP019POL) – REVIEWED August 2026
  • All Lines of Business
  • Annual Review – Aligned language to strengthen policy
Non-Reimbursed Revenue Code (PP008POL) – REVIEWED August 2026
  • All Lines of Business
  • Annual Review – Aligned language to strengthen policy
Observation Services (PP004POL) – REVIEWED August 2026
  • All Lines of Business
  • Annual Review – Aligned language to strengthen policy
Pre/Post Claims Payment Review (PP049POL) – REVIEWED August 2026
  • All Lines of Business
  • Annual Review – Aligned language to strengthen policy
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Categories: Provider Newsletter

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