Tufts Health Plan is informed when CMS and state insurance agencies issue new billing and reimbursement guidelines in response to the COVID-19 emergency. These guidelines are reviewed by Tufts Health Plan and implemented, as appropriate.
Tufts Health Plan has been making changes to our operating systems as decisions or regulations have been released. Most of the system changes for COVID-19 have been made and will be completed by May 18, 2020
. We recognize that some claims may not have been processed according to the policies related to COVID-19, and we apologize for any inconvenience this has caused. As we finalize these last changes, we will automatically reprocess impacted claims rendered between March 6, 2020
and May 18, 2020
. We expect most impacted claims to be reprocessed by May 26, 2020
Providers should follow guidelines on this page for dates of services listed during the COVID-19 emergency and continue to submit claims as they currently do. Providers should not await billing instructions from Tufts Health Plan. For all other billing guidelines, refer to the Professional Services and Facilities Payment Policy
and the benefit-specific payment policies located in the Provider Resource Center
Tufts Health Plan follows AMA CPT/HCPCS coding guidelines and accepts all standard modifiers submitted in accordance with the appropriate CPT/HCPCS procedure code(s). Refer to current industry standard coding guidelines for a complete list of modifiers and their usage as well as content-specific payment policies for more information.