Product Benefit Updates
Posted on February 26, 2024
Each year, Health New England reviews gaps in care and access to appointments, and works closely with regulatory entities to ensure programs are in place to meet the needs of our members. The following benefits are in place for 2024:
Behavioral Health Wellness
Effective 4/1/2024, our Fully Funded Commercial* members will have access to one in-person behavioral health wellness visit per year. Members may make an appointment with an in network PCP or licensed behavioral health counselor. These visits range anywhere from 20 to 60 minutes, and the office should bill separately and not with the Member’s annual PCP visit.
To bill for these services, please use procedure code 90791, and include diagnosis Z13.30 with modifier 33 both in their respective first positions. There should be no copay or coinsurance applied towards our HMO benefit plans, but deductibles amounts are still applicable on our high deductible benefit plans.
Before providing services, you may call our Member Service team to verify if the member received the benefit for the year.
*This may be applicable to some self-funded employer group members. Please call Member
Services at (800) 842-4464, extension 5025, to understand benefits.
Adolescent Mental Health
As of January 1, 2024, Health New England expanded our Teladoc® Mental Health offering to include mental health care for adolescents aged 13 – 17 years. Members may access these services through the primary member’s account. The parent/guardian on behalf of the adolescent completes the intake and consent forms in the app or web browser.
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. You may also send an email to providerrelations@hne.com.
