ProviderMatters

Payment Policy Updates (July 2026)

Posted on June 29, 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
Once in a Lifetime Procedure (PP067POL) – NEW September 2026
  • All Lines of Business
  • New Policy – Outlines what we do today and strengthening our Payment Policy Portfolio
Skin Substitutes (PP068POL) – NEW September 2026
  • All Lines of Business
  • New Policy – Outlines what we do today and strengthening our Payment Policy Portfolio
Wound Care and Surgical Debridement (PP069POL) – NEW September 2026
  • All Lines of Business
  • New Policy – Outlines what we do today and strengthening our Payment Policy Portfolio
Laboratory Professional Services (PP041POL) September 2026
  • All Lines of Business
  • Updated venipuncture language
Readmission to Inpatient Level of Care (PP007POL) September 2026
  • All Lines of Business
  • Aligned billing language to strengthen Policy
Transportation Services (PP028POL) July 2026
  • All Lines of Business
  • Annual Review, aligned language to strengthen policy
Individual Consideration Services (PP037POL) July 2026
  • Medicaid Line of Business
  • Annual Review, aligned approval date
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Categories: Provider Newsletter

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