Reimbursement policies
We want to assist physicians, facilities, and other providers in accurate claims submissions and to outline the basis for reimbursement if the service is covered by a member’s benefit plan.
Reimbursement policy code disclaimer
These policies may be superseded by state, federal, or CMS requirements. Providers and facilities are required to use industry-standard codes for claim submissions. Services should be billed with CPT® codes, HCPCS codes, and/or revenue codes. The billed code(s) should be fully supported in the medical record and/or office notes. Industry practices are constantly changing, and we reserve the right to review and revise policies periodically.
Note: Determination of coverage under a member's benefit plan does not necessarily ensure reimbursement.
Related information
Policies
Coming Soon!