Reimbursement Policies
Add-on Codes - Anniversary review approved 5-21-25
After Hours and Weekend Care - 3-27-25 Anniversary Review
Autism/Applied Behavior Analysis (ABA) Reimbursement Policy – Anniversary Review & Updates 11-20-24
Behavioral Health Services Documentation - Retired 10-7-24. Please refer to Documentation Protocols for further guidance.
Bundle Codes Reimbursement Policy - Anniversary Review 11-20-24
Consultation Services Reimbursement Policy - Update 11-20-24
Drug Testing Reimbursement Policy - Anniversary review approved 5-21-25
Electroconvulsive Therapy Reimbursement Policy - Anniversary Review & Update 11-20-24
Facility-Based Behavioral Health Program Professional Fees Reimbursement Policy - Anniversary review 5-21-25
Facility-Based Behavioral Health Program Reimbursement Policy - Anniversary review 5-21-25
Facility-Based Behavioral Health Program – Medicare – New Approved 10-7-24
Health and Behavior Assessment and Intervention Reimbursement Policy Commercial & Medicare - 3-27-25 Anniversary Review
Inappropriate Primary Diagnosis Codes Reimbursement Policy - Anniversary Review & Updates 11-20-24
License Level Reimbursement Policy - Anniversary review approved 6-27-24
Maximum Frequency Per Day - Anniversary review approved 5-21-25
Medicare Incident to Bill - 3-27-25 Anniversary Review
National Correct Coding Initiative Reimbursement Policy - Policy update 5-21-25
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 Policy update 5-21-25
Non-Reimbursable HCPCS Codes - Anniversary review approved 6-27-24
Non-Covered HCPCS Codes - Policy update 5-21-25
Opioid Treatment Program Reimbursement Policy - 5-21-25 Anniversary Review & updates
Outpatient Family Therapy Reimbursement Policy - Anniversary review approved 10-7-24
Outpatient Service Clean Claim Form Submission - Anniversary Review approved 10-7-24
Outpatient Services Outside A Program Reimbursement Policy - Anniversary review approved on 10-7-24
Outpatient Services Rendered Under Supervision - Update 11-20-24
Procedure and Place of Service Reimbursement Policy - 3-27-25 Anniversary Review
Professional Technical Component Reimbursement Policy Retired Policy 11-20-24
Prolonged Services Reimbursement Policy - Commercial and Medicare - Anniversary review approved 5-21-25
Psychological and Neuropsychological Testing Reimbursement Policy - Update 11-20-24
Same Day Same Service Reimbursement Policy – Anniversary Review approved 10-7-24
Spravato Reimbursement Policy - Anniversary review approved 4-3-24
Services Incident to a Supervising Health Care Provider - New Policy Commercial LOB 12-1-24
Telemental Health Services Reimbursement Policy - Commercial - Commercial Update 1-1-25; update added Q&As 1 and 2
Telemental Health Services Reimbursement Policy – Medicaid Policy update 6-15-25
Telemental Health Services Reimbursement Policy – Medicare Updated 1/2025; added Q&A 1