Claims Denials Begin January 1, 2025 for Past-Due Revalidations
Effective January 1, 2025, claims for providers that have not completed revalidation by their due date will be denied. Providers who successfully revalidate may resubmit their claims.
ATTENTION: State Plan or B3 Modifiers on Behavioral Health Claims
All first position modifiers that indicated a State Plan (SP) service or a “B3” service (i.e. HE, HK, U4, TM, HM, HJ, TT, HT, HQ, HF) were deleted from the State Behavioral Health Services (SBHS) Billing Manual on January 1, 2024.
Effective for dates of service on or after January 1, 2025, Regional Accountable Entities (RAEs) were instructed to reject or deny claims that included the SP or B3 modifiers on claims in the first position.
If you receive a claim rejection, please resubmit a new claim without the SP or B3 modifier. If you receive a claim denial, please resubmit either a new claim or a corrected claim without the SP or B3 modifier.
HCPF is aware that some providers are experiencing denials due to use of these modifiers and is sharing this policy again to reduce future denials.
|