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UCare's Payment Policies

These payment policies describe UCare’s application of payment rules and methodologies for claims submitted under UCare’s health benefit plans. This information is offered as a helpful resource regarding UCare payment policies. UCare cannot address every possible aspect of a reimbursement scenario.

Name Policy Number Effective Date Last Update
Mental Health - Adult Crisis Response Services SC14P0027A5 2018-05-01 2020-09-10
Mental Health - Adult Rehabilitative Mental Health Services (ARMHS) SC15P0049A3 2018-05-01 2021-08-05
Mental Health - Adult Targeted Case Management SC14P0044A2 2018-05-01 2021-08-05
Anesthesia (Medicare) UM14P0008A6 2014-08-01 2020-10-06
Anesthesia (MHCP) SC14P0005A6 2014-08-14 2020-07-06
Mental Health - Assertive Community Training (ACT) SC14P0021A3 2018-05-01 2020-09-24
Mental Health - Certified Family Peer Specialist SC17P0065A3 2018-05-01 2020-10-20
Certified Peer Specialist SC14P0026A3 2018-05-01 2021-08-05
Mental Health - Children’s Therapeutic Support Services (CTSS) Child Day Treatment SC14P0010A3 2018-05-01 2019-08-28
Mental Health - Children's Clinical Care Consultations SC17P0061A3 2018-05-01 2020-09-24
Mental Health - Childrens Crisis Response Services SC14P0033A5 2018-05-01 2021-04-22
Mental Health - Children's Residential Treatment SC17P0062A2 2018-05-01 2020-10-06
Mental Health - Children’s Therapeutic Support Services (CTSS) SC17P0058A1 2018-05-01 2020-10-28
Community Health and Public Health Clinics (MHCP) SC140028A1 2015-01-05 2015-01-05
Community Health Worker (CHW) - MHCP SC14P0029A6 2015-01-01 2020-07-06
Mental Health - Diagnostic Assessments and Updates SC14P0004A3 2018-05-01 2020-10-19
Mental Health - Dialectical Behavior Intensive Therapy Outpatient Program (DBT IOP) SC14P0003A2 2018-05-01 2021-08-05
Doula Services SC15P0048A2 2015-08-20 2021-06-07
Mental Health - Explanation of Findings SC15P0053A3 2018-05-01 2020-10-20
Mental Health - Family Psychoeducation SC17P0055A3 2018-05-01 2020-10-20
Free Standing Birthing Centers SC14P000&A6 2014-10-13 2020-07-06
Inpatient Hospital Readmission UM19P0035A1 2019-12-30 2021-06-22
Mental Health - Intensive Residential Treatment Services (IRTS) SC14P0025A4 2018-05-01 2020-10-20
Mental Health - Neuropsychological Services SC14P0011A2 2018-05-01 2021-06-07
Mental Health - Neuropsychological Services SC14P0011A2 2018-05-01 2021-05-28
Mental Health - Partial Hospitalization SC14P0034A3 2018-05-01 2021-04-06
Primary Care and Vaccines for Children Incentive Program SC14P0006A2 2014-10-13 2016-01-01
Provider Payment Policy Modifier Grid No Number 2018-01-01 2020-11-24
Mental Health - Provider Travel Time SC15P0050A3 2018-05-01 2021-08-08
Mental Health - Psychiatric Consultations to Primary Care Providers SC17P0064A3 2018-05-01 2021-06-07
Mental Health - Psychological Testing SC17P0057A3 2018-05-01 2021-05-07
Mental Health - Psychotherapy SC14P0043A2 2018-05-01 2021-05-07
Mental Health - Psychotherapy for Crisis SC17P0066A2 2018-05-01 2021-05-07
Mental Health - Youth Assertive Community Treatment (Youth ACT) SC14P0009A3 2018-05-01 2021-06-07