Outpatient Behavioral Health Pass-Through Visits

PW_AD091787
 
Behavioral Health Outpatient Visits 
Please note that Empire no longer requires prior authorization for traditional behavioral health outpatient therapy visits for all fully-insured products including Exchange products. Many of our self-funded groups have also removed review of traditional outpatient therapy visits, however, some groups continue to require a review after a certain number of pass-through visits. With the new calendar year please be certain to verify benefits for new patients to ensure you are aware of any requirements. 
Empire has also removed prior authorization requirements for psychological testing (CPT codes 96101, 96102 and 96103) for all fully-insured products including Exchange products. Some self-funded groups continue to require review for this service. Please be certain to verify benefits for psychological testing for new patients to ensure you are aware of any prior authorization requirements. 
Partial hospitalization, intensive outpatient, applied behavior analysis, electro-convulsive therapy (ECT), trans-cranial magnetic stimulation (TMS) and ambulatory detoxification services continue to require prior authorization from the first visit.  
©2015 Empire BlueCross BlueShield

Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans, serving residents and businesses in the 28 eastern and southeastern counties of New York State. All external sites will open in a new browser window. Please view our Website Privacy Policy for more information.