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

July 2015

Payment Policy Update: Coverage of CPT 99211


Effective for date of service beginning October 1, 2015, Harvard Pilgrim will not reimburse the low level evaluation and management CPT code 99211, with or without a modifier 25, when it is billed with the chemotherapy/non-chemotherapy drug infusion codes CPT 96401-96549 or therapeutic and/or diagnostic injection codes CPT 96365-96379 by the same provider on the same date of service for the same member.

For more information, please refer to Harvard Pilgrim’s updated Evaluation and Management Payment Policy.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator