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February 2023
We’ve made changes to reimbursement policy for psychiatric residential treatment facilitiesAs you may have read in a provider alert in December, Blues Cross Blue Shield of Michigan has developed a new reimbursement policy for psychiatric residential treatment facilities, or PRTFs, effective Dec. 1, 2022. This new policy doesn’t affect facilities or hospital systems that are under contract with us for services through our Hospital Contracting area. With this policy, Blue Cross recognizes diagnosis-specific pricing related to feeding disorders. If diagnosis code F50.9 is reported on a claim and is authorized by Blue Cross, then it will trigger a specialty rate as reflected on the PRTF fee schedule. This fee schedule change is only for outpatient psychiatric clinics. |
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