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Optum Reimbursement Policies

Add-on Codes

Behavioral Health Services Documentation - Updated 8-5-2021

Bundle Codes Reimbursement Policy 

Consultation Services Reimbursement Policy

Drug Testing Reimbursement Policy - Updated 5-24-2021

Duplication of Claims Reimbursement Policy - Retired 5-24-2021

Electroconvulsive Therapy Reimbursement Policy - Updated 5-24-2021

Facility-Based Behavioral Health Program Professional Fees Reimbursement Policy - Updated 8-24-2021

Facility-Based Behavioral Health Program Reimbursement Policy - Updated 8-24-2021

Health and Behavior Assessment and Intervention Reimbursement Policy Commercial & Medicare

Inappropriate Primary Diagnosis Codes Reimbursement Policy

Incident to Billing Reimbursement Policy - Retired 5-24-2021

License Level Reimbursement Policy - Updated 9-16-2021

Maximum Frequency Per Day

Medicare Incident to Bill - Updated 5-24-2021

National Correct Coding Initiative Reimbursement Policy

Non-Emergent Transport and Lodging

Non-Reimbursable HCPCS Codes

Non-Covered HCPCS Codes

Opioid Treatment Program Reimbursement Policy

Outpatient Family Therapy Reimbursement Policy - Updated 8-21-2021

Outpatient Service Clean Claim Form Submission

Outpatient Services Outside A Program Reimbursement Policy - Updated 8-21-2021

Procedure and Place of Service Reimbursement Policy

Professional Technical Component Reimbursement Policy

Psychological and Neuropsychological Testing Reimbursement Policy

Same Day Same Service Reimbursement PolicyNew Policy 9-1-21 

Specimen Validity Testing Reimbursement Policy (Retired)

Spravato Reimbursement Policy

Telemental Health Services Reimbursement Policy - Commercial - Updated 8-24-2021

Telemental Health Services Reimbursement Policy – Medicaid  - Updated 9-16-2021

Telemental Health Services Reimbursement Policy – Medicare