Optum Reimbursement Policies

Add-on Codes - Anniversary review approved 5-22-23

After Hours and Weekend Care - New policy approved 3-27-23

Autism/Applied Behavior Analysis (ABA) Reimbursement Policy – New effective 9-15-22

Behavioral Health Services Documentation - Anniversary review approved 3-27-23

Bundle Codes Reimbursement Policy - Updated 10-24-22

Consultation Services Reimbursement Policy  - Update approved 5-22-23

Drug Testing Reimbursement Policy - Anniversary Review approved 5-22-23

Duplication of Claims Reimbursement Policy - Retired 5-24-21

Electroconvulsive Therapy Reimbursement Policy - Updated 10-24-22

Facility-Based Behavioral Health Program Professional Fees Reimbursement Policy - Update approved 1-20-23

Facility-Based Behavioral Health Program Reimbursement Policy - Update approved 7-26-23 

Health and Behavior Assessment and Intervention Reimbursement Policy Commercial & Medicare - Anniversary review approved 3-27-23

Inappropriate Primary Diagnosis Codes Reimbursement Policy - Update approved 7-26-23

Incident to Billing Reimbursement Policy - Retired 5-24-2021

License Level Reimbursement Policy - Anniversary review approved on 7-26-23

Maximum Frequency Per Day - Anniversary review  approved 5-22-23

Medicare Incident to Bill - Anniversary review approved 3-27-23

National Correct Coding Initiative Reimbursement Policy - Anniversary review  approved 5-22-23

New Patient Visit – New policy approved 7-26-23 

Non-Emergent Transport and Lodging - Anniversary review  approved 5-22-23

Non-physician Health Care Billing Evaluation and Management Codes Reimbursement Policy - New policy approved 5-22-23

Non-Reimbursable HCPCS Codes - Anniversary review approved on 7-26-23

Non-Covered HCPCS Codes - Anniversary review approved 7-26-2023

Opioid Treatment Program Reimbursement Policy - Anniversary review approved 1-19-23

Outpatient Family Therapy Reimbursement Policy - Anniversary review approved on 8-15-22

Outpatient Service Clean Claim Form Submission - Updated 10-24-22

Outpatient Services Outside A Program Reimbursement Policy - Anniversary review approved on 7-26-23

Procedure and Place of Service Reimbursement Policy - Anniversary review approved 3-27-23

Professional Technical Component Reimbursement Policy - Anniversary review  approved 5-22-23

Prolonged Services Reimbursement Policy - Commercial and Medicare - Update approved 1-19-23

Psychological and Neuropsychological Testing Reimbursement Policy - Updated 10-24-22

Same Day Same Service Reimbursement Policy – Update approved 1-20-23 

Spravato Reimbursement Policy - Anniversary review approved 3-27-23

Telemental Health Services Reimbursement Policy - Commercial - Updated approved 5-22-23

Telemental Health Services Reimbursement Policy – Medicaid  - Update approved 7-26-23

Telemental Health Services Reimbursement Policy – Medicare   - Update 3-27-23