Medicare provides payment for outpatient psychiatric hospital services when they are medically reasonable and necessary for the purpose of diagnostic study or be reasonably expected to improve the patient's condition.
Access the below mental health related information from this page.
- Community Mental Health Center (CMHC) Partial Hospitalization Program (PHP) Billing Guide
- Covered and Non-covered Services
- Hospital-based PHP Billing Guide
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 4, Section 260 - Explains billing requirements for the Partial Hospitalization Program
- CMS IOM, Publication 100-02, Medicare Benefit Policy Manual, Chapter 6, Section 70 – Defines what outpatient psychiatric services are as well as specific coverage guidelines for the various services provided
- CMS Medicare Learning Network (MLN) Matters Special Edition (SE)1607
Last Updated Jul 26, 2017
The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.