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 4-3-24
Facility-Based Behavioral Health Program Reimbursement Policy - Update approved 4-3-24
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