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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 2024-05-17
Mental Health - Adult and Children's Crisis Response Services SC14P0027A5 2018-05-01 2024-09-25
Mental Health - Adult Rehabilitative Mental Health Services (ARMHS) SC15P0049A3 2018-05-01 2024-05-02
Mental Health - Adult Residential Crisis Stabilization SC19P0070A1 2018-05-01 2024-06-18
Anesthesia (Medicare) UM14P0008A6 2014-08-01 2024-04-19
Anesthesia (MHCP) SC14P0005A6 2014-08-14 2024-04-19
Mental Health - Assertive Community Treatment (ACT) SC14P0021A3 2018-05-01 2024-06-18
Mental Health - Certified Family Peer Specialist SC17P0065A3 2018-05-01 2024-06-24
Certified Peer Specialist SC14P0026A3 2018-05-01 2024-06-24
Mental Health - Children’s Therapeutic Support Services (CTSS) Child Day Treatment SC14P0010A3 2018-05-01 2024-07-12
Mental Health - Children's Clinical Care Consultations SC17P0060A1 2018-05-01 2024-07-12
Mental Health - Children's Residential Treatment SC17P0062A2 2018-05-01 2024-07-12
Mental Health - Children’s Therapeutic Support Services (CTSS) SC17P0058A1 2018-05-01 2024-09-06
Community Health Worker (CHW) - MHCP SC14P0029A6 2015-01-01 2024-05-02
Mental Health - Diagnostic Assessment SC14P0004A3 2018-05-01 2024-07-24
Mental Health - Dialectical Behavior Intensive Therapy Outpatient Program (DBT IOP) SC14P0031A2 2018-05-01 2024-07-24
Doula Services SC15P0048A5 2015-08-20 2024-05-17
Mental Health - Explanation of Findings SC15P0053A3 2018-05-01 2024-05-17
Mental Health - Family Psychoeducation SC17P0055A3 2018-05-01 2024-05-17
Free Standing Birthing Centers SC14P0007A6 2014-10-13 2024-04-19
Mental Health - Health Behavior Assessment Intervention SC17P0061A2 2018-05-01 2024-07-24
Home Health Services UX24P0003A1 2024-01-01 2024-05-02
Inpatient Hospital Readmission SC19P0072A1 2019-12-30 2024-04-19
Mental Health - Intensive Residential Treatment Services (IRTS) SC14P0025A4 2018-05-01 2024-06-24
Mental Health - Neuropsychological Services SC14P0011A2 2018-05-01 2024-05-17
Mental Health - Partial Hospitalization SC14P0034A3 2018-05-01 2024-07-24
Provider Modifier Grid No Number 2018-01-01 2023-05-01
Mental Health - Provider Travel Time SC15P0050A3 2018-05-01 2024-05-17
Providers Not Participating with Medicare UM24P0039A1 2025-01-01 2024-10-10
Providers Not Participating with UCare MHCP SC24P0076A1 2025-01-01 2024-11-25
Mental Health - Psychiatric Consultations to Primary Care Providers SC17P0064A3 2018-05-01 2024-05-31
Mental Health - Psychiatric Residential Treatment Facility (PRTF) SC20P0071A1 2020-01-01 2024-05-02
Mental Health - Psychological Testing SC17P0057A3 2018-05-01 2024-05-31
Mental Health - Psychotherapy SC14P0043A2 2018-05-01 2024-05-31
Mental Health - Psychotherapy for Crisis SC17P0066A2 2018-05-01 2024-05-31
Mental Health - Youth Assertive Community Treatment (Youth ACT) SC14P0009A3 2018-05-01 2024-06-18