Harvard Pilgrim Health Care Home
  Learn more.
  Sign up for HPHConnect.
Medical Management
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Office Support
Provider Manual
Medicare Advantage
Research & Teaching
Resources & Links
Print    Text Size

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.

Email this article to a colleague   

Receive Network Matters by e-mail

Network Matters Archives

Download printer-friendly version


Medicare Advantage StrideSM (HMO) Plans Offered in January

Harvard Pilgrim #1 for 10th Year in a Row

Pediatric Dental and Vision Coverage

Harvard Pilgrim Collaborates on New Hampshire Medicaid Program


Specialty Pharmacy Name Change

Prior Authorization for Cinryze

P&T Committee Updates

Fecal Bacteriotherapy Now Covered with Prior Authorization

HEDIS Spotlight: Follow-up Care for Children Taking ADHD Medication

Recognizing Social Phobia in the Primary Care Setting

Reminder: Synagis for the Upcoming RSV Season


C Codes Now Accepted

Outpatient Fee Schedule Updates

2014 CPT and HCPCS codes

Change in Proration for Inpatient Stays with Partial Eligibility

Reminder: HPHConnect Account Revalidation


Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,

Kristin Edmonston,
Production Coordinator