Effective for claims with dates of service beginning January 1, 2014, Harvard Pilgrim will accept C codes from facilities. C codes are temporary HCPCS codes established for use by the Centers for Medicare and Medicaid Services (CMS) under the hospital outpatient prospective payment system (OPPS).
Harvard Pilgrim will update all applicable hospital fee schedules to include C codes. While most C codes will be eligible for reimbursement, some will not be covered. For more information, please refer to the updated Non-Covered Services Payment Policy.
Harvard Pilgrim has also updated our Coding Overview and Outpatient Facility Fee Schedule payment policies to reflect this policy change.