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

October 2016

Outpatient Fee Schedule Updates

Effective January 1, 2017, Harvard Pilgrim is updating our current standard outpatient facility fee schedule for acute rehabilitation hospitals, freestanding ambulatory surgery centers, and skilled nursing facilities. As of November 1, 2016, you may request 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) 2016 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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Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator