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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.

View the UCare Payment Policies Modifier Grid here.

Name Policy Number Effective Date Last Update
Mental Health - Adult and Child Targeted Case Management SC14P0044A2 2018-05-01 2023-08-18
Mental Health - Adult and Children's Crisis Response Services SC14P0027A5 2018-05-01 2023-03-16
Mental Health - Adult Rehabilitative Mental Health Services (ARMHS) SC15P0049A3 2018-05-01 2023-09-28
Mental Health - Adult Residential Crisis Stabilization SC19P0070A1 2018-05-01 2024-01-09
Anesthesia (Medicare) UM14P0008A6 2014-08-01 2023-06-22
Anesthesia (MHCP) SC14P0005A6 2014-08-14 2023-06-22
Mental Health - Assertive Community Treatment (ACT) SC14P0021A3 2018-05-01 2023-03-16
Mental Health - Certified Family Peer Specialist SC17P0065A3 2018-05-01 2023-02-16
Certified Peer Specialist SC14P0026A3 2018-05-01 2023-2-16
Mental Health - Children’s Therapeutic Support Services (CTSS) Child Day Treatment SC14P0010A3 2018-05-01 2023-05-11
Mental Health - Children's Clinical Care Consultations SC17P0060A1 2018-05-01 2024-01-09
Mental Health - Children's Residential Treatment SC17P0062A2 2018-05-01 2023-06-22
Mental Health - Children’s Therapeutic Support Services (CTSS) SC17P0058A1 2018-05-01 2023-05-11
Community Health Worker (CHW) - MHCP SC14P0029A6 2015-01-01 2023-06-08
Mental Health - Diagnostic Assessment SC14P0004A3 2018-05-01 2023-12-20
Mental Health - Dialectical Behavior Intensive Therapy Outpatient Program (DBT IOP) SC14P0031A2 2018-05-01 2023-03-02
Doula Services SC15P0048A5 2015-08-20 2024-02-13
Mental Health - Explanation of Findings SC15P0053A3 2018-05-01 2023-05-11
Mental Health - Family Psychoeducation SC17P0055A3 2018-05-01 2023-05-25
Free Standing Birthing Centers SC14P0007A6 2014-10-13 2024-01-09
Mental Health - Health Behavior Assessment Intervention SC17P0061A2 2018-05-01 2023-05-11
Inpatient Hospital Readmission SC19P0072A1 2019-12-30 2023-05-25
Mental Health - Intensive Residential Treatment Services (IRTS) SC14P0025A4 2018-05-01 2023-07-28
Mental Health - Neuropsychological Services SC14P0011A2 2018-05-01 2023-05-25
Mental Health - Partial Hospitalization SC14P0034A3 2018-05-01 2023-11-14
Provider Modifier Grid No Number 2018-01-01 2023-05-01
Mental Health - Provider Travel Time SC15P0050A3 2018-05-01 2023-05-11
Mental Health - Psychiatric Consultations to Primary Care Providers SC17P0064A3 2018-05-01 2023-05-11
Mental Health - Psychiatric Residential Treatment Facility (PRTF) SC20P0071A1 2020-01-01 2024-02-09
Mental Health - Psychological Testing SC17P0057A3 2018-05-01 2023-05-25
Mental Health - Psychotherapy SC14P0043A2 2018-05-01 2023-05-25
Mental Health - Psychotherapy for Crisis SC17P0066A2 2018-05-01 2023-05-25
Mental Health - Youth Assertive Community Treatment (Youth ACT) SC14P0009A3 2018-05-01 2023-06-08