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Updated payment policies now available
July 7, 2026

This article is for all providers caring for our members

The following payment policies, updated in Q2 2026, are now available on Provider Central.

Payment policy

Updates

Applied Behavior Analysis (Autism)

  • Added Licensed Assistant Applied Behavior Analyst (LAABA)/Board-Certified Assistant Behavior Analysts (BCaBA) reimbursement information effective September 1, 2026

Community Behavioral Health Centers

  • Newly documented payment policy effective August 1, 2026

Community Mental Health Centers

  • Updated template
  • Clarified end date for ABA services through CMHC
  • Updated CBHC reimbursement information and included reference to CBHC payment policy

CPT and HCPCS Modifiers

  • Added new AC modifier effective July 1, 2026

Evaluation and Management

  • Corrected typographical errors within “Other non-reimbursed services” code table

Expanded Molecular Panel Testing of Cancers

  • Added new codes 0631U and 0648U effective July 1, 2026

General Coding and Billing

  • Updated Category III range to 1053T

Home Health Care

  • Annual review; updated template

Hospice

  • Annual review; updated template

Non-Reimbursable Services

  • Updated template
  • Updated non-reimbursed list links for professional providers and facility providers

Skilled Nursing Facility

  • Annual review; updated template

Telehealth (Telemedicine) – Medical Services

  • Added reimbursement information for interprofessional consultation codes (99446-99449 and 99451-99452) effective April 1, 2026

Telehealth (Telemedicine) – Mental Health

  • Added reimbursement information for interprofessional consultation codes (99446-99449 and 99451-99452) effective April 1, 2026

Download our payment policies.

To download our payment policies, log in and click Find a Payment Policy on the right side of your home page. Or, go to Office Resources>Policies & Guidelines>Payment Policies.

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