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 9/15/2022
Behavioral Health Services Documentation - Anniversary Review Approved 3-27-23
Bundle Codes Reimbursement Policy - Updated 10-24-2022
Consultation Services Reimbursement Policy - Update Approved 1-20-2023
Drug Testing Reimbursement Policy - Anniversary Review Approved 5-22-23
Duplication of Claims Reimbursement Policy - Retired 5-24-2021
Electroconvulsive Therapy Reimbursement Policy - Updated 10-24-2022
Facility-Based Behavioral Health Program Professional Fees Reimbursement Policy - Update Approved 1-20-2023
Facility-Based Behavioral Health Program Reimbursement Policy - Update Approved 5-22-23
Health and Behavior Assessment and Intervention Reimbursement Policy Commercial & Medicare - Anniversary Review Approved 3-27-23
Inappropriate Primary Diagnosis Codes Reimbursement Policy - Anniversary Review Approved 1-19-23
Incident to Billing Reimbursement Policy - Retired 5-24-2021
License Level Reimbursement Policy - Updated 10-24-2022
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
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 5/22/2023
Non-Reimbursable HCPCS Codes - Anniversary Review approved on 8/15/2022
Non-Covered HCPCS Codes - Anniversary Review approved on 8/15/2022
Opioid Treatment Program Reimbursement Policy - Anniversary Review – Approved 1-19-2023
Outpatient Family Therapy Reimbursement Policy - Anniversary Review approved on 8/15/2022
Outpatient Service Clean Claim Form Submission - Updated 10-24-2022
Outpatient Services Outside A Program Reimbursement Policy - Anniversary Review approved on 8/15/2022
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 1-19-2023
Psychological and Neuropsychological Testing Reimbursement Policy - Updated 10-24-2022
Same Day Same Service Reimbursement Policy – Update Approved 1-20-2023
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 - Anniversary Review Approved 1-19-23
Telemental Health Services Reimbursement Policy – Medicare - Update 3-27-23