Z6_H2IC1K80OG6VF0QL49827U00Q6
Home > Claims, Coding, Payment
Z7_H2IC1K80OG6VF0QL49827U0060
Web Content Viewer
Z7_H2IC1K80OG6VF0QL49827U0066
Web Content Viewer
Updated payment policies now available
July 1, 2025

This article is for all providers caring for our members

The following payment policies, updated in Q2 2025, are now available on Provider Central.

Payment policy Updates
Acupuncture
  • Annual review; updated template
  • Edited to clarify billing scenario 5
Advance Care Planning
  • Annual review; updated template
Assisted Reproductive Technology
  • Annual review
  • Adjusted fee amount per vial of sperm
  • Added S4025
  • Updated billing scenarios
CPT and HCPCS Modifiers
  • Quarterly review; updated template
  • Edited to clarify RR and UE modifier reimbursement
Dental Care
  • Annual review; updated template
Durable Medical Equipment  
  • Edited to clarify RR and UE modifier reimbursement
Expanded Molecular Panel Testing of Cancers
  • Added new codes 0562U, 0569U, 0571U effective July 1, 2025
General Coding and Billing
  • Quarterly review; updated template
  • Added billing guidelines for two-dose pack of nasal naloxone effective July 1, 2025 in compliance with Massachusetts Division of Insurance Filing Guidance 2025-F
Human Leukocyte Antigen
  • Annual review; updated template
Immunizations
  • Added new code 90635
  • Revised description for 90620
Medical Nutrition Therapy/Licensed Dietician Nutritionist
  • Annual review; updated template
Non-Reimbursable Services
  • Updated non-reimbursed list links for professional and facility providers
Outpatient Surgical Services - Facility
  • Annual review; updated template
PT/OT- Independent Practice
  • Updated template
  • Removed iontophoresis from non-reimbursed section
  • Edited to clarify general benefit information and billing guidelines for PT/OT services in compliance with Massachusetts Division of Insurance Filing Guidance 2025-F

Download our payment policies.

To download our payment policies, log in and click Find a Payment Policy on the right side of your home page. Or, go to Office Resources>Policies & Guidelines>Payment Policies.

MPC_011625-1P-2