We are happy to share with you this Special Edition October 2022 to update you on Inpatient Psychiatric Placement from the Emergency Department (ED), an observation unit, or non-psychiatric inpatient.<\/p>\n
Hospital Emergency Department\/Behavioral Health Crisis Intervention<\/strong><\/p>\n Effective beginning with 11\/1\/2022 dates of service<\/strong><\/em>, and in accordance with the Department of Insurance Bulletin 2022-08, Health New England will follow the guidance to ensure our Commercial members waiting for appropriate inpatient psychiatric placement from the Emergency Department (ED), an observation unit, or non-psychiatric inpatient are expedited. In addition, we will reimburse the hospital Emergency Department no less than the recommended MassHealth rate for this \u201ccrisis intervention mental health and ongoing monitoring and stabilization services.\u201d<\/p>\n The guidance asks that we continue to follow the regulations of the Expedited Psychiatric Inpatient Admission Policy (EPIA). With that said, we expect the hospital EDs to continue to notify and update the mental health status with our Behavioral Health Department.<\/p>\n In addition, for reimbursement, we expect you will submit the correct procedure code of S9485 and follow our Claim Submission and Reimbursement guidelines documented in our Provider Manual. The manual is located at https:\/\/healthnewengland.org\/providers\/provider-manual\/billing-reimbursement<\/a>.<\/p>\n
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