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Reimbursement Policies 

Add-on Codes - Anniversary review approved 6-27-24

After Hours and Weekend Care - Anniversary review approved 4-3-24

Autism/Applied Behavior Analysis (ABA) Reimbursement Policy – Anniversary Review approved 11-20-23

Behavioral Health Services Documentation - Retired 10-7-24. Please refer to Documentation Protocols for further guidance. 

Bundle Codes Reimbursement Policy - Anniversary Review approved 11-20-23

Consultation Services Reimbursement Policy  - Anniversary Review approved 9-19-23

Drug Testing Reimbursement Policy - Anniversary review approved 6-27-24

Electroconvulsive Therapy Reimbursement Policy - Anniversary Review approved 11-20-23

Facility-Based Behavioral Health Program Professional Fees Reimbursement Policy - Update approved 5-17-24

Facility-Based Behavioral Health Program Reimbursement Policy - Update approved 5-17-24 

Health and Behavior Assessment and Intervention Reimbursement Policy Commercial & Medicare - Anniversary review approved  4-3-24

Inappropriate Primary Diagnosis Codes Reimbursement Policy - Anniversary Review approved 11-20-23

License Level Reimbursement Policy - Anniversary review approved 6-27-24

Maximum Frequency Per Day - Anniversary review approved 6-27-24

Medicare Incident to Bill - Anniversary review approved 4-3-24

National Correct Coding Initiative Reimbursement Policy - Anniversary review approved 6-27-24

New Patient Visit – Anniversary review approved 6-27-24 

Non-Emergent Transport and Lodging - Anniversary review approved 5-22-23 (Retired 6-27-24

Non-physician Health Care Billing Evaluation and Management Codes Reimbursement Policy Anniversary Review Approved 4-3-24 

Non-Reimbursable HCPCS Codes -  Anniversary review approved 6-27-24

Non-Covered HCPCS Codes - Anniversary review approved 6-27-24

Opioid Treatment Program Reimbursement Policy - 2024 update approved 1-24-24

Outpatient Family Therapy Reimbursement Policy - Anniversary review approved 9-19-23

Outpatient Service Clean Claim Form Submission - Anniversary Review approved 9-19-23

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

Outpatient Services Rendered Under Supervision - New Policy - Effective 10-1-24

Procedure and Place of Service Reimbursement Policy - Update approved 4-3-24

Professional Technical Component Reimbursement Policy Anniversary review approved 6-27-24 

Prolonged Services Reimbursement Policy - Commercial and Medicare - Anniversary review approved 6-27-24

Psychological and Neuropsychological Testing Reimbursement Policy - Anniversary Review approved 9-19-23

Same Day Same Service Reimbursement Policy – Anniversary Review approved 9-19-23 

Spravato Reimbursement Policy - Anniversary review approved 4-3-24

Telemental Health Services Reimbursement Policy - Commercial - Update approved 6-27-24 

Telemental Health Services Reimbursement Policy – Medicaid  - Update approved 4-3-24

Telemental Health Services Reimbursement Policy – Medicare   - Update approved 4-3-24