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ADMINISTRATIVE POLICIES

Administrative admin-023 Administrative Denials May 29, 2024 May 29, 2024 May 29, 2025
Administrative ADMIN-004 Behavioral Health Residential Treatment Centers September 04, 2024 September 04, 2024 September 04, 2025
Administrative admin-002 Behavioral Health Services Level of Care Determination September 25, 2024 September 25, 2024 September 25, 2025
Administrative admin-015 Category III CPT Codes February 01, 2024 February 01, 2024 February 01, 2025
Administrative admin-001 Clinical Criteria for Review Determinations December 13, 2023 December 13, 2023 December 13, 2024
Administrative admin-008 Custodial/Respite Care July 01, 2024 April 24, 2024 April 24, 2025
Administrative admin-021 Dismissal: Failure to Follow Filing Procedures May 29, 2024 May 29, 2024 May 29, 2025
Administrative admin-016 Hospice Eligibility Determination Policy January 24, 2024 January 24, 2024 January 24, 2025
Administrative admin-003 Medical Services Level of Care Determination December 13, 2023 December 13, 2023 December 13, 2024
Administrative admin-020 Noncovered Behavioral Health-Related Services February 28, 2024 February 28, 2024 February 28, 2025
Administrative ADMIN-018 Personal Care Services December 13, 2023 December 13, 2023 December 13, 2024
Administrative admin-022 Retrospective Service Reviews May 29, 2024 May 29, 2024 May 29, 2025
Administrative admin-017 Temporary COVID-19 Telemedicine Policy May 29, 2024 May 29, 2024 May 29, 2025
Administrative admin-006 Women’s Health and Cancer Rights Act Clarification July 31, 2024 July 31, 2024 July 31, 2025
Administrative admin-014 Hospital Acquired Conditions and Never Events October 23, 2024 October 23, 2024 October 23, 2025
Administrative ADMIN-005 Clinical Reconsideration of Organizational Determinations April 28, 2024 February 28, 2024 February 28, 2025