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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.

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