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Optum Reimbursement Policies

Add-on Codes - Anniversary Review  Approved 5-23-22

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  - Anniversary Review approved on  8/15/2022

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 - Updated 4-1-2022

Facility-Based Behavioral Health Program Reimbursement Policy - Updated 4-1-2022

Health and Behavior Assessment and Intervention Reimbursement Policy Commercial & Medicare - Updated 4-1-2022

Inappropriate Primary Diagnosis Codes Reimbursement Policy - Updated 12-14-2021

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 - Updated 4-1-2022

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 PolicyAnniversary Review approved on  8/15/2022 

Specimen Validity Testing Reimbursement Policy (Retired)

Spravato Reimbursement Policy - Updated 4-1-2022

Telemental Health Services Reimbursement Policy - Commercial - Updated 9-26-2022

Telemental Health Services Reimbursement Policy – Medicaid  - Policy Update approved on 9-26-2022

Telemental Health Services Reimbursement Policy – Medicare   - Policy Update approved on  9-26-2022