{"id":8825,"date":"2026-01-06T15:12:52","date_gmt":"2026-01-06T15:12:52","guid":{"rendered":"https:\/\/hnetalk.com\/provider\/?p=8825"},"modified":"2026-01-06T16:32:18","modified_gmt":"2026-01-06T16:32:18","slug":"payment-policy-updates-january-2026","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/payment-policy-updates-january-2026\/","title":{"rendered":"Payment Policy Updates (January 2026)"},"content":{"rendered":"

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\u202fhealthnewengland.org\/Providers\/Resources<\/a>.<\/p>\n

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.<\/p>\n

The following policies were reviewed and updated:<\/strong><\/em><\/p>\n\n\n\n\n\n\n\n\n\n
Payment Policy<\/strong><\/td>\n\u00a0Effective Date<\/strong><\/td>\nNotes<\/strong><\/td>\n<\/tr>\n
Updated – Multiple Procedures<\/strong><\/p>\n

 <\/td>\n

01\/01\/2026<\/p>\n

 <\/p>\n

 <\/td>\n

\n
    \n
  • Created payment policy to document existing operational practices.<\/li>\n
  • All Lines of Business.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Updated – Modifier<\/strong><\/p>\n

\u00a0<\/strong><\/p>\n

 <\/td>\n

\u00a0\u00a001\/01\/2026<\/p>\n

 <\/p>\n

 <\/td>\n

\n
    \n
  • Added clarifying language for contracted providers<\/li>\n
  • All Lines of Business.<\/li>\n<\/ul>\n

     <\/td>\n<\/tr>\n

Updated \u2013 Evaluation & Management<\/strong><\/p>\n

\u00a0<\/strong><\/p>\n

 <\/td>\n

\u00a003\/01\/2026<\/td>\n\n
    \n
  • 99459 covered, but not separately reimbursable for Commercial line of business only.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Updated \u2013 Preventive<\/strong><\/p>\n

\u00a0<\/strong><\/p>\n

 <\/td>\n

\u00a003\/01\/2026<\/td>\n\n
    \n
  • 99459 covered, but not separately reimbursable for Commercial line of business only.<\/li>\n<\/ul>\n

     <\/td>\n<\/tr>\n

Updated – Bilateral Procedures<\/strong><\/p>\n

\u00a0<\/strong><\/p>\n

 <\/td>\n

\u00a003\/01\/2026<\/td>\n\n
    \n
  • Updated language to provide better clarity around billing reimbursement guidelines.<\/li>\n
  • All Lines of Business.<\/li>\n<\/ul>\n

     <\/td>\n<\/tr>\n

New Update:<\/strong><\/p>\n

Provider Claims Queue Office Hours<\/strong><\/td>\n

01\/05\/2026<\/td>\n\n
    \n
  • Provider Support queue extension 5026 will be closed daily for lunch from 12:00 – 1:00 p.m., Monday-Friday.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    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\u202fhealthnewengland.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, […]<\/p>\n","protected":false},"author":11,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[],"class_list":["post-8825","post","type-post","status-publish","format-standard","hentry","category-provider-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-2il","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8825","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=8825"}],"version-history":[{"count":3,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8825\/revisions"}],"predecessor-version":[{"id":8828,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8825\/revisions\/8828"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=8825"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=8825"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=8825"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}