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 & 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 6-27-24

Electroconvulsive Therapy Reimbursement Policy - Anniversary Review & Update 11-20-24

Facility-Based Behavioral Health Program Professional Fees Reimbursement Policy - Update 11-20-24

Facility-Based Behavioral Health Program Reimbursement Policy - Update approved 11-20-24 

Facility-Based Behavioral Health Program – Medicare – New Approved 10-7-24

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

Inappropriate Primary Diagnosis Codes Reimbursement Policy - Anniversary Review & Updates 11-20-24

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 - Update 11-20-24

Opioid Treatment Program Reimbursement Policy - Anniversary review & updates 11-20-24

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 - Update approved 4-3-24

Professional Technical Component Reimbursement Policy Retired Policy 11-20-24

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

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

Telemental Health Services Reimbursement Policy – Medicaid  - Update approved 10-7-24

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