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

January 2014

2014 Fee Schedule Updates


On April 1, 2014, Harvard Pilgrim will update its:

  • Standard professional fee schedule, incorporating recently released Medicare relative value units (RVUs) and laboratory rates for 2014
  • Durable medical equipment (DME) fees, which may also include changes resulting from Harvard Pilgrim’s annual review of purchase (NU), maintenance (MS), and rental (RR) terms
  • Standard professional and facility fee schedules for a subset of molecular pathology codes, based on an ongoing review of Medicare local carrier pricing

Beginning in mid-February, providers may request 2014 sample fee schedules by calling the Provider Service Center at 800-708-4414.

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HPHCURRENT EVENTS

Commitment to the Principles of Centered Care

Reminder: Electronic Funds Transfer is Now Available

CLINICIAN CORNER

Update: Aloxi, Anzemet, and Emend Prior Authorization Medial Review Criteria

New Medical Policy: Cell-free Fetal DNA Testing

Medical Policy for Genetic Testing

Reminder: Measures Aimed at Boosting SNF/PCP Care Coordination

P&T Committee Updates

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OFFICE ASSISTANT

2014 Fee Schedule Updates

Update: Gastroenterology Payment Policy

New CMS 1500 Claim Form Now Accepted

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