Updates to Habilitative Services - Effective Jan. 1, 2017
Learn about the updates before submitting your claims
November 02, 2016 - As a result of Maryland legislation, updates have been made regarding coverage of habilitative services.
What does this mean for you?
- Beginning Jan. 1, 2017 and moving forward, you should bill the SZ modifier along with the procedure code when submitting claims for habilitiative services.
- Covered habilitative services include PT, OT, ST, Applied Behavioral Analysis (ABA) and Oral (dental).
- There are no changes to your current pre-authorization process for all services listed above.
Looking for more information?
- To view the medical policies associated with these services, refer to the Medical Policy Reference Manual at www.carefirst.com/medicalpolicy. Search for:
- Look for covered procedure codes associated with PT, OT, ST, and ABA services in our December issue of BlueLink.
- Look for covered procedure codes associated with Oral (dental) services in our December issue of BlueImpressions.
Sign-up for training
Get Your Questions Answered
For webinar and seminar training opportunities related to prior authorization and specifically PT/OT/ST, visit www.carefirst.com/cpet, click Webinars & Seminars and select your Provider Type.
Or register using one of the links below:
Wed., Nov. 9 @ 11:00am
Wed., Nov. 16 @ 10:00am
Wed., Dec. 7 @ 2:00pm
Thurs., Dec. 22 @ 11:00am