Anthem Blue Cross and Blue Shield will begin reimbursing for services provided by unlicensed clinical behavioral health providers actively seeking licensure 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.

Note: These billing guidelines do not apply to Community Mental Health Centers (CMHCs). CMHCs should continue billing for services as you do today.