Reminder: Behavioral Health Revenue Code Alignment

As a reminder, in accordance with the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) Revenue Codes Requiring Procedure Codes, Facility Reimbursement Policy (PDF), Blue Cross NC requires HCPCS/CPT® codes be submitted with appropriate corresponding revenue codes.

Blue Cross NC has identified providers incorrectly billing behavioral health services with inappropriate revenue codes.  Any behavioral health services billed with an inappropriate revenue code will be denied. For any denied claims, providers may submit a corrected claim using a more appropriate revenue code that aligns with the CPT/HCPCS submitted.

This policy update applies to Commercial, Inter-Plan Programs (IPP)Host, State Health Plan (SHP), Federal Employee Program (FEP) and Medicare Advantage. This policy update does not apply to IPPHome.