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Optum Reimbursement Policies

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

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 - Anniversary review approved 3-27-23

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 5-22-23

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 - 2024 update approved 1-24-24

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

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

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 Anniversary Review Approved 4-3-24 

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

Non-Covered HCPCS Codes - Update approved 4-3-2024

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

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

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 - 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 4-3-24

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

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