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March 2023

Behavioral health providers: Hold claims for dates of service on or after Jan. 1, 2023, with codes *99354 and *99355

Until further notice, behavioral health providers should hold claims for dates of service on or after Jan. 1, 2023, that contain procedure codes *99354 and *99355. These codes are for non-medical behavioral health prolonged services.

The American Medical Association terminated codes *99354 and *99355, effective Jan. 1, 2023. If you submit claims with these codes for dates of service on or after Jan. 1, 2023, they won’t be accepted, even if the claims contain codes that are payable.

Claims with dates of service prior to Jan. 1, 2023, can still be billed with these codes.

We’re working on identifying active codes that can be billed in place of the terminated codes. Once we have a solution:

  • We’ll communicate it in a provider alert and a newsletter article.
  • You’ll be able to bill claims retroactive to Jan. 1, 2023.

This applies to all our lines of business:

  • Blue Cross Blue Shield of Michigan commercial
  • Blue Care Network commercial
  • Medicare Plus Blue℠
  • BCN Advantage℠

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2022 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.