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Harvard Pilgrim Health Care (Point32Health)

Last updated: March 2026

Harvard Pilgrim Health Care (Point32Health) is a health insurer. They report 290 insurance plans covering 460K providers across 17K billing codes.

Data Version

Price Transparency Machine-Readable Files Snapshot
March 2026
Overview
290

Plans

XX% vs prev
460K

Providers (NPIs)

XX% vs prev
150K

Tax IDs

XX% vs prev
17K

Billing Codes

XX% vs prev
43M

Data Rows

XX% vs prev
Geographic Coverage

Top states by provider count:

Massachusetts (55K)
California (38K)
Texas (27K)
Florida (23K)
Data Breakdown
Plans Type (HIOS vs EIN)

HIOS

40

EIN

250

NPIs

Individual

450K

Group

5.4K

Tax IDs

EIN

120K

NPI (Individual)

30K

NPI (Group)

4

Billing Code Type
CodesRows

CPT

10K

36M

HCPCS

4.4K

6.3M

CDT

490

870K

APR-DRG

1.3K

110K

MS-DRG

770

8.5K

RC

62

8.1K

Billing Class
Rows

Professional

43M

Institutional

120K

Negotiated Type
Rows

Fee Schedule

43M

Negotiated

110K

Percentage

11K

Top States by # NPIs

Massachusetts

55K

California

38K

Texas

27K

Florida

23K

New York

23K

Top Taxonomies by # NPIs

Clinical Social Worker

93K

Mental Health Counselor

58K

Professional Counselor

54K

Psychiatric/Mental Health Nurse Practitioner

27K

Behavior Analyst

25K

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Historical Metrics
MonthPlansNPIsTax IDsBilling CodesData Rows
March 2026
290460K150K17K43M
February 2026
310450K150K17K54M
January 2026

December 2025

November 2025

Show all 12 months

Data Coverage Scorecard
5/6 — Good

This payer scores 5/6 on data quality (Good). Areas that don't meet the threshold: valid tax ids.

Professional & Institutional Rates

Data includes both professional and institutional billing class rates

Valid Tax IDs

Less than 80% of Tax IDs are EIN or NPI (Organization) type

HIOS Plan

Data includes at least one HIOS-identified plan

Low Derived/Percentage Rates

Less than 10% of negotiation entries are derived or percentage type

Standard Code Coverage

Sufficient CPT and HCPCS code coverage with low proportion of LOCAL entries

Common Taxonomies

NPIs in the dataset cover at least 50 distinct provider taxonomies

Methodology

The scorecard evaluates each payer's monthly price transparency data against six quality criteria:

  • If 5–6 criteria pass, the overall rating is Good.

  • If 3–4 criteria pass, the rating is Acceptable.

  • If 0–2 criteria pass, the rating is Poor.

Behavioral, RX, and other specialty networks may not pass all criteria but can still contain complete and usable data.

PRICE TRANSPARENCY DATA

Explore Harvard Pilgrim Health Care (Point32Health) negotiated rates.