Mental health care coding, including substance use treatment

We issue member-specific authorization numbers with each prior authorization notice. You must use this number on each billing statement claim.

Please see "claims administration" in billing and claims contacts for information on where to send mental health billing statements and claims.

Following these procedures will ensure appropriate processing of your claims.

• Submit substance use treatment billings in date order when possible.

Mental health providers must include the following taxonomy code information on both electronic (837p) and paper (CMS-1500) claims:

• Billing provider taxonomy code: To indicate the type of service provided by the billing entity. Allows us to pay providers more accurately and to better track these limited benefits for our patients.
• Pay-to provider taxonomy code: Required if different from the billing provider.
• Rendering provider taxonomy code: Required if different from the billing provider.