This communication applies to Commercial and Medicare Advantage plans from Anthem Blue Cross and Blue Shield (Anthem) in New Hampshire.

 

Effective January 1, 2023, Anthem will begin reimbursing for services provided by unlicensed clinical behavioral health providers who possess at least a master’s level education and who are actively pursuing behavioral health professional licensure for the eligible (or successor) codes listed below. Provider groups assigned by Anthem to Beacon Health Options, Inc.* are included in this change.

 

Supervision under a licensed New Hampshire participating provider is required for any services provided by an unlicensed clinical behavioral health provider seeking licensure. The licensed supervising provider must be permitted to supervise such unlicensed provider for services within their scope of practice and assume professional responsibility for the patient and services performed in compliance with the licensed supervising provider’s applicable licensing law and regulations.

 

Such providers will be required to bill under their supervising provider with the modifier HO as an identifier and be reimbursed per the standard master’s level reimbursement for the below codes eligible to be billed by a master’s level provider. Codes will be updated in accordance with any annual CPT® code maintenance that is required. Anthem reserves the right to audit medical records upon request. If there is conflict between this article and any other Anthem communication or policy, this article shall prevail. Anthem will be making changes to member certificates to reflect these changes. If you have questions, reach out to your Provider Relationship Account Consultant.

 

CPT codes

82075

96167

99492

96164

90785

96168

99493

96165

90791

96170

99494

99443

90792

96171

G0511

99484

90832

98966

G0512

90849

90833

98967

G2011

90853

90834

98968

G2213

90887

90836

99251

G2214

99306

90837

99252

S9485

99307

90838

99253

99309

99308

90839

99254

99310

96156

90840

99255

99441

96158

90846

99304

99442

96159

90847

99305

96127

 


* Beacon Health Options is an independent company providing behavioral health services on behalf of Anthem Blue Cross and Blue Shield.


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Reimbursement for services by clinical behavioral health providers seeking licensure