Optum Reimbursement Policies
Add-on Codes - Update Approved 1-20-2023
Autism/Applied Behavior Analysis (ABA) Reimbursement Policy – New effective 9/15/2022
Behavioral Health Services Documentation - Updated 10-24-2022
Bundle Codes Reimbursement Policy - Updated 10-24-2022
Consultation Services Reimbursement Policy - Update Approved 1-20-2023
Drug Testing Reimbursement Policy - Anniversary Review Approved 5-23-22
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 1-20-2023
Health and Behavior Assessment and Intervention Reimbursement Policy Commercial & Medicare - Updated 4-1-2022
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 5-23-22
Medicare Incident to Bill - Updated 4-1-2022
National Correct Coding Initiative Reimbursement Policy - Anniversary Review Approved 5-23-22
Non-Emergent Transport and Lodging - Anniversary Review Approved 5-23-22
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 - Updated effective 1-1-2022
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 - Update Approved 1-20-2023
Professional Technical Component Reimbursement Policy - Anniversary Review Approved 5-23-22
Prolonged Services Reimbursement Policy - Commercial and Medicare - New 4-1-2022
Psychological and Neuropsychological Testing Reimbursement Policy - Updated 10-24-2022
Same Day Same Service Reimbursement Policy – Update Approved 1-20-2023
Specimen Validity Testing Reimbursement Policy (Retired)
Spravato Reimbursement Policy - Update Approved 1-20-2023
Telemental Health Services Reimbursement Policy - Commercial - Anniversary Review Approved 1-19-23
Telemental Health Services Reimbursement Policy – Medicaid - Anniversary Review Approved 1-19-23
Telemental Health Services Reimbursement Policy – Medicare - Anniversary Review Approved 1-19-23