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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

October 2013

Outpatient Fee Schedule Updates


Effective January 1, 2014, Harvard Pilgrim is updating our current standard outpatient facility fee schedule for acute rehabilitation hospitals, freestanding ambulatory surgery centers, and skilled nursing facilities. This change does not apply to providers that are not on the most current Harvard Pilgrim standard fee schedule. As of November 1, 2013, you may request 2014 sample fee schedules by contacting your contract manager.

Acute Rehabilitation Hospitals and Ambulatory Surgery Centers
Harvard Pilgrim is basing our fee schedule updates for acute rehabilitation hospitals and freestanding ambulatory surgery centers on the Centers for Medicare and Medicaid Services (CMS) 2013 Ambulatory Payment Classifications (APC). For more information, please see the Outpatient Facility Fee Schedule Payment Policy or contact your contract manager.

Skilled Nursing Facilities
The new standard outpatient fee schedule for skilled nursing facilities is limited to physical therapy, occupational therapy, and speech therapy. For more information, please see the Skilled Nursing Facility Payment Policy.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,
Editor

Kristin Edmonston,
Production Coordinator