Archived Payment Reimbursement Policies (PRP)

Archived PHP Payment Reimbursement Policies (PRP)

Advanced Practice Providers and Mid-Level Practitioners (PRP-09)
Effective Date: 06.20.2022
Advanced Practice Providers and Mid-Level Practitioners (PRP-09)
Effective Date: 5/18/2021
Advance Practice Providers and Mid-Level Practitioners (PRP-09)
Effective Date: 7/2/20
Advance Practice Providers and Mid-Level Practitioners (PRP-09)
Effective Date: 6/1/19
Behavioral Health Facility Services (PRP-21)
Effective Date: 12.28.2022
Behavioral Health Facility Services (PRP-21)
Effective Date: 2/17/2022
Bilateral and Multiple Procedures (PRP-16)
Effective Date: 08.01.2023
Bilateral and Multiple Procedures (PRP-16)
Effective Date: 07.27.2022
Bilateral and Multiple Procedures (PRP-16)
Effective Date: 8/27/2021
Bilateral and Multiple Procedures (PRP-16)
Effective Date: 3/22/21
Bilateral and Multiple Procedures (PRP-16)
Effective Date: 2/1/20
Spravato Nasal Spray Esketamine (PRP-20)
Effective Date: 12.06.2022
340B Drug and Biological Discount Program (Modifiers JG and TB) (PRP-20)
Effective Date: 6/22/2021
COVID-19 Testing and Treatment (PRP-17)
Effective Date: 04.19.2023
COVID-19 Testing and Treatment (PRP-17)
Effective Date: 04.19.2023
COVID-19 Testing and Treatment (PRP-17)
Effective Date: 02.28.2023
COVID-19 Testing and Treatment (PRP-17)
Effective Date: 07.27.2022
COVID-19 Testing and Treatment (PRP-17)
Effective Date: 10/26/2021
Drug Testing in Pain Management and Substance Use Disorders Treatment (PRP-02)
Effective Date: 04.14.2023
Drug Testing in Pain Management and Substance Use Disorders Treatment (PRP-02)
Effective Date: 10.25.2021
Drugs and Biologicals (PRP-11)
Effective Date: 03.27.2023
Drugs and Biologicals (PRP-11)
Effective Date: 04.15.2022
Drugs and Biologicals (PRP-11)
Effective Date: 5/19/2021
Drugs and Biologicals (PRP-11)
Effective Date: 7/2/20
Drugs and Biologicals (PRP-11)
Effective Date: 8/22/19
Evaluation and Management Services (PRP-18)
Effective Date: 01.01.2023
Evaluation and Management Services (PRP-18)
Effective Date: 03.02.2022
Evaluation and Management Services (PRP-18)
Effective Date: 1/28/2021
Hearing Aids and Services (PRP-10)
Effective Date: 12/1/20
Hearing Aids and Services (PRP-10)
Effective Date: 8/22/19
Hospice Services (PRP-04)
Effective Date: 04.14.2023
Hospice Services (PRP-04)
Effective Date: 12.06.2022
Hospice Services (PRP-04)
Effective Date: 8/31/2021
Hospice Services (PRP-04)
Effective Date: 10/1/20
Hospice Services (PRP-04)
Effective Date: 1/1/19
Inpatient Rehabilitation (IPR) Facility Services (PRP-14)
Effective Date: 12.06.2022
Inpatient Rehabilitation (IPR) Facility Services (PRP-14)
Effective Date: 8/31/2021
Inpatient Rehabilitation (PRP-14)
Effective Date: 1/28/21
Medical Record Request Standard (PRP-05)
Effective Date: 12.06.2022
Medical Record Request Standard (PRP-05)
Effective Date: 12/7/2021
Observation Care Facility Charges (PRP-01)
Effective Date: 12.06.2022
Observation Care Facility Charges (PRP-01)
Effective Date: 1/12/22
Observation Care Facility Charges (PRP-01)
Effective Date: 9/3/19
Observation Care Facility Charges (PRP-01)
Effective Date: 1/1/19
Oral Sleep Apnea Device E0485 E0486 (PRP-13)
Effective Date: 04.01.2022
Oral Sleep Apnea Device E0485 E0486 (PRP-13)
Effective Date: 7/8/2021
Oral Sleep Apnea Device E0485 E0486 (PRP-13)
Effective Date: 08/12/20
Oral Sleep Apnea Device (PRP-13)
Effective Date: 10/11/19
Professional Laboratory Services (PRP-19)
Effective Date: 04.14.2023
Professional Laboratory Services (PRP-19)
Effective Date: 12.06.2022
Professional Laboratory Services (PRP-19)
Effective Date: 12/17/2021
Professional Laboratory Services (PRP-19)
Effective Date: 2/15/21
Sub-Acute Rehabilitation (SAR) Skilled Nursing Facility (SNF) Charges (PRP-12)
Effective Date: 08.31.2021
Sub-acute Rehabilitation (PRP-12)
Effective Date: 1/28/21
Telemedicine Services (PRP-15)
Effective Date: 03.27.2023
Telemedicine Services (PRP-15)
Effective Date: 02.16.2022
Telemedicine Services (PRP-15)
Effective Date: 10/25/2021
Telemedicine Services (PRP-15)
Effective Date: 02/15/2021
Telemedicine Services (PRP-15)
Effective Date: 4/15/20
Unlisted CPT-HCPCS Codes (PRP-03)
Effective Date: 10.16.2023
Unlisted CPT-HCPCS Codes (PRP-03)
Effective Date: 12.06.2022
Unlisted CPT-HCPCS Codes (PRP-03)
Effective Date: 10/26/21
Unlisted CPT-HCPCS Codes (PRP-03)
Effective Date: 1/1/20
Unlisted CPT-HCPCS Codes (PRP-03)
Effective Date: 1/1/19
Unspecified Diagnosis Codes (PRP-06)
Effective Date: 12.28.2022
Unspecified Diagnosis Codes (PRP-06)
Effective Date: 2/17/2022
Unspecified Diagnosis Codes (PRP-06)
Effective Date: 4/16/2021
Unspecified Diagnosis Codes (PRP-06)
Effective Date: 7/2/20

Archived Payment Reimbursement Policies (PRP)

Archived PHP Payment Reimbursement Policies (PRP)

Advanced Practice Providers and Mid-Level Practitioners (PRP-09)

Advanced Practice Providers and Mid-Level Practitioners (PRP-09)

Advance Practice Providers and Mid-Level Practitioners (PRP-09)

Advance Practice Providers and Mid-Level Practitioners (PRP-09)

Behavioral Health Facility Services (PRP-21)

Behavioral Health Facility Services (PRP-21)

Bilateral and Multiple Procedures (PRP-16)

Bilateral and Multiple Procedures (PRP-16)

Bilateral and Multiple Procedures (PRP-16)

Bilateral and Multiple Procedures (PRP-16)

Bilateral and Multiple Procedures (PRP-16)

Spravato Nasal Spray Esketamine (PRP-20)

340B Drug and Biological Discount Program (Modifiers JG and TB) (PRP-20)

COVID-19 Testing and Treatment (PRP-17)

COVID-19 Testing and Treatment (PRP-17)

COVID-19 Testing and Treatment (PRP-17)

COVID-19 Testing and Treatment (PRP-17)

COVID-19 Testing and Treatment (PRP-17)

Drug Testing in Pain Management and Substance Use Disorders Treatment (PRP-02)

Drug Testing in Pain Management and Substance Use Disorders Treatment (PRP-02)

Drugs and Biologicals (PRP-11)

Drugs and Biologicals (PRP-11)

Drugs and Biologicals (PRP-11)

Drugs and Biologicals (PRP-11)

Drugs and Biologicals (PRP-11)

Evaluation and Management Services (PRP-18)

Evaluation and Management Services (PRP-18)

Evaluation and Management Services (PRP-18)

Hearing Aids and Services (PRP-10)

Hearing Aids and Services (PRP-10)

Hospice Services (PRP-04)

Hospice Services (PRP-04)

Hospice Services (PRP-04)

Hospice Services (PRP-04)

Hospice Services (PRP-04)

Inpatient Rehabilitation (IPR) Facility Services (PRP-14)

Inpatient Rehabilitation (IPR) Facility Services (PRP-14)

Inpatient Rehabilitation (PRP-14)

Medical Record Request Standard (PRP-05)

Medical Record Request Standard (PRP-05)

Observation Care Facility Charges (PRP-01)

Observation Care Facility Charges (PRP-01)

Observation Care Facility Charges (PRP-01)

Observation Care Facility Charges (PRP-01)

Oral Sleep Apnea Device E0485 E0486 (PRP-13)

Oral Sleep Apnea Device E0485 E0486 (PRP-13)

Oral Sleep Apnea Device E0485 E0486 (PRP-13)

Oral Sleep Apnea Device (PRP-13)

Professional Laboratory Services (PRP-19)

Professional Laboratory Services (PRP-19)

Professional Laboratory Services (PRP-19)

Professional Laboratory Services (PRP-19)

Sub-Acute Rehabilitation (SAR) Skilled Nursing Facility (SNF) Charges (PRP-12)

Sub-acute Rehabilitation (PRP-12)

Telemedicine Services (PRP-15)

Telemedicine Services (PRP-15)

Telemedicine Services (PRP-15)

Telemedicine Services (PRP-15)

Telemedicine Services (PRP-15)

Unlisted CPT-HCPCS Codes (PRP-03)

Unlisted CPT-HCPCS Codes (PRP-03)

Unlisted CPT-HCPCS Codes (PRP-03)

Unlisted CPT-HCPCS Codes (PRP-03)

Unlisted CPT-HCPCS Codes (PRP-03)

Unspecified Diagnosis Codes (PRP-06)

Unspecified Diagnosis Codes (PRP-06)

Unspecified Diagnosis Codes (PRP-06)

Unspecified Diagnosis Codes (PRP-06)

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