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Section IV. LHD Programs and Services

• Behavioral Health and Substance Use Disorder (SUD) Services​​​​​​​​​​​
  • SUD FY 2022 MD Medicaid Fee Schedule
    
  • PBHS FY 2022 Health Home
    
  • PBHS FY 2022 MH Individual and OMHC
    
  • PBHS FY 2022 PRP and Specialty Programs
    
  • PBHS FY 2022 PRP Cascade
    
  • PBHS FY 2022 - 1915
    
  • SUD MD Medicaid Fee Schedule
  • Billing Behavioral Health Services
  • Aetna Behavioral Health Provider Manual 2021
  • Vivitrol Billing and Coding Guide
    
  • Behavioral Health Services Common Billing Codes
    
  • MLN Fact Sheet: Behavioral Health Integration Services
    
  • MLN Booklet: Medicare Mental Health​
    
  • SAMHSA: Coding for Screening and Brief Intervention Reimbursement
    
  • Alcohol and Drug Requirements Certification Licensure
  • CMS Medicaid SUD & Mental Health Parity Final Rule FAQs
  • Public Mental Health System Rates
  • MDH Coding Guidelines for Screening Tools for Primary Care​​​​​​​​​​​
    
  • MDH Memo Reconciliation and Recoupment BHASO Update
    
  • JHHC Provider Notice ABA No Longer Covered as a Telehealth Visit for USFHP
    
  • ​MDH BHA Telehealth Post Emergency Revised 7.16.21​​​​​​​​​​
  • COVID Student and Young Adult Resource Guide for Coping During COVID-19
  • BHA Clinical Letter Help the Helpers Supports Overview 3.8.21
  • MD Medicaid UBH Claims Guide
    
  • Beacon Health Options Outpatient Mental Clinics Rendering Provider Requirements for Claims Submission - April 12, 2019
  • COMAR 10.63 Key Personnel​
    
  • CMS Memo: Implementation of Section 5052 of the Support for Patients and Communities Act – State Plan Option under Section 1915(l) of the Social Security Act
  • Community-Based Substance Use Disorder Fee Schedule - Updated May 6, 2020
  • BHA Memo: Guidance Regarding Telehealth Expansion Regulations - March 12, 2020​
    
  • Combination of SUD Services - Effective July 1, 2017​
    
  • Memo: Medicaid Billing for Drug Testing and Screening -  January 2017
    
  • Memo: Drug Testing Payment Charges
  • Maryland Health Connection Fact Sheet: Substance Use Disorder Treatment
    
  • Strategy to Combat Opioid Abuse, Misuse, and Overdose
    
  • Memo: Payment for Presumptive and Definitive Urine Drug Testing - April 22, 2019
    
  • OPTUM Medicaid / MCOs / Uninsured
    • Optum Provider Bulletin 6.2.22​
      
    • Optum Data 2000 Waiver & PMH COS 6.9.22
      
    • Optum Missing Claims Images Provider Alert 6.8.22
      
    • Optum Estimated Payment Forgiveness
      
    • Optum Provider Alert New Fee Schedule BH​
    • Optum May 2022 BHA Updates​
    • Optum May 2022 Letter from BHA​
      
    • Optum Provider Bulletin 5.4.22​
      
    • Optum Provider Bulletin 5.11.22 ​​
      
    • ​OPTUM April 2022 Monthly Update from BHA
      
    • OPTUM BHA SOR Spring 2022 Newsletter
      
    • OPTUM Incedo Provider Portal Auth Issues 3.31.22
      
    • OPTUM Management of Neg Balances Moving Forward 4.13.22
      
    • OPTUM Spring 2022
      
    • OPTUM Update on Authorization Issues in Incedo 4.7.22
      
    • OPTUM Updated Fee Schedules
      
    • OPTUM Bed Hold Process Guidance - RCS RRP
      
    • OPTUM New Gambling Auth Plans
      
    • OPTUM BH Monthly Partner Letter March 2022
      
    • OPTUM March 2022 Monthly Updates from BHA
    • OPTUM State Negative Balances due to Retro-Eligibility Re-Processing 1.7.22
      
    • OPTUM Bed Hold Authorization Plans 1.5.22
      
    • OPTUM BHA and MDH Tobacco Control Survey 11.24.21
      
    • OPTUM EDIT PS Web EVS - Medicaid Provider
      
    • OPTUM ICD-10 Diagnosis List Revisions
      
    • OPTUM Recroupment of Retro-Eligibility and Overpayments
      
    • OPTUM Auto Updating of Expired Licenses
      
    • OPTUM ARPA PBHS Rate Increases
      
    • OPTUM Provider Alert Guidance on the Continuation of Telehealth for ABA Services
      
    • OPTUM Recoupment Sequence 11.17.21
      
    • OPTUM Remaining Authorization Units Feature in Incedo Provider Portal
      
    • OPTUM_ ARP Rate Increase New Fee Schedule Nov. 1 2021​
    • OPTUM Use of UA Modifier
    • OPTUM Claims Denials and Rejections Quick Reference Guide
      
    • OPTUM Maryland Public Behavioral Health System (PBHS) Level of Care Appendix​
      
    • OPTUM Incedo Quick Reference Guide​
      
    • OPTUM Changes to CARC Codes
      
    • OPTUM Provider Alert Individual Provider License Expiration
      
    • OPTUM New Excecutive Order for Congregate and Residential Programs​
      
    • OPTUM Backdated Authorizations
      
    • OPTUM Funding for SAMHSA
      
    • OPTUM Staggering of PRP Authorizations
      
    • OPTUM National Network Manual
      
    • OPTUM Change Index OPTUM National Network Manual
      
    • OPTUM Provider Alert Updated Fee Schedule
      
    • ​OPTUM 99072 Code Use
      
    • OPTUM Residential Eating Disorder Program for Adults and Adolescents​
    • Optum Maryland PBHS Provider Billing Appendix - Revised 5-8-2020
      
    • OPTUM Maryland Provider Manual Product Implementations BH2535 - Final Revised 02.05.20
      
    • Optum Authorization to Disclose SUD Treatment Information for Coordination of Care
    • OPTUM PROVIDER ALERT 2022 Provider Self-Assessment Tools
      
    • OPTUM PROVIDER ALERT Backdating Exception Authorization Request
    • OPTUM PROVIDER ALERT Negative Balance Recoupment​​​​​​
    • OPTUM Timely Filing Waiver
    • OPTUM Update to Clinical Request Forms
    • OPTUM Vaccine Administration Information Form​​
    • OPTUM Provider Alert Payable Provider Types and Services in the ER
    • OPTUM Provider Alert Changes to Submitting Authorization Correction Requests
    • OPTUM Provider Alert Updated Guidance for PRP RRP Referrals August 2021
    • OPTUM Provider Alert SUD Residential Treatment Notice
    • OPTUM Telehealth Updates Correction July 16, 2021​​​​​
      
    • OPTUM SUD IOP Alert 3.19.2021
    • OPTUM Psych Medical Necessity Alert 3.1.2021
    • OPTUM Uninsured Eligibilty Alert 2.26.21
      
    • ​OPTUM SUD Authorization Parameters Update
      
    • COVID Fact Sheet Recovery and Wellness Support​
    • OPTUM Fee Schedule Update
    • OPTUM Extension for Authorization Entry
    • OPTUM Psychological Testing Authority
    • OPTUM PBHS Provider Manual January 2020​​​
      
    • OPTUM Updates to TCM Forms 10.30.20
      
    • OPTUM Provider Alert 10.19.2020
      
    • OPTUM Maryland Billing Appendix BH2536 Final Revised 5.8.20
    • CMS Memo: Implementation of Section 5052 of the Support for Patients and Communities Act – State Plan Option under Section 1915(l) of the Social Security Act​
      
    • Memo: Public Behavioral Health System Administrative Service Organization Vendor Change - September 2019​
      
    • Optum Provider Alert: Optum as New Behavioral Health ASO for Maryland - November 15, 2019​
      
  • Medicare BH Mental Health
    • CMS MLN Opioid Treatment Programs
    • CMS Billing for Methadone 1.20.21
    • MLN Matters SE18001: Proper Coding for Specimen Validity Testing Billed in Combination with Drug Testing
      
    • MLN Booklet: Behavioral Health Integration Services - Final 2019
• Dental
  • Dental Procedure Codes and Nomenclature (CDT Codes)
  • Aetna Dental and Oral Surgery Claim Documentation Guidelines
  • CareFirst CO
  • VID-19 Dental
    
  • Maryland Medicaid Dental Fee Schedule and Procedure Codes (CDT)​
    
  • Maryland Oral Health Resource Guide 2020 2021 Edition
    
  • Ryan White Dental Facts 2016 2021
  • UHC Dental Policy Update Bulletin January 2022​​​​​
    
  • 2021 Healthy Smiles Provider Manual
    
  • FY21 Dental Rates
    
  • Maryland Medicaid Telehealth​ Dentistry Guidance - Effective March 5, 2020
  • CMSC Informational Bulletin: Aligning Dental Payment Policies and Periodicity Schedules in the Medicaid and CHIP Programs
    
  • MDH: Adult Dental Pilot Program Overview​
    
  • Maryland Healthy Smiles: Adult Dental Pilot Program Provider FAQs
  • CareFirst: Dental Claims Submission Guidelines​
• Diabetes Program
  
  • HealthChoice DPP Manual Updated 4.24.20
  • HealthChoice DPP Lifestyle Change Program
  • Nutrition and Diabetes Prevention Programs​​
    
  • MDPP CMS Billing and Payment FAQs
  • MDPP CMS Quick Reference Guide to Payment and Billing​
  • MDPP Expanded Model PHE Flexibilities 3.30.2020​
  • ​CMS CDC Diabetes Prevention Program (DPP) Expanded Model Roles Fact Sheet
    
  • HealthChoice DPP FAQs - 4-15-20​
    
• ​​​​​​EPSTD
• ​Audiology, Physical Therapy, and SPSDT Provider Manual Final 7.8.20
• EPSTD Provider Policy Manual Effective 7.1.18
• Maryland Healthy Kids Preventive Health Schedule​​
  
• Hepatitis B
  
  • Hep B Screen Medicare 2018​
• Hepatitis C (HCV)​
  • Hepatitis C
  • Medicaid Hepatitis C Therapy Prior Authorization Form​
    
  • MLN Matters: Screening for Hepatitis C Virus in Adults​
    
  • Hepatitis C Sample Treatment Plan
  • Clinical Criteria for Hepatitis C Therapy
  • Hepatitis C CPT Codes
    
• HIV Services
  • Billing for HIV Services
  • COMAR 10.09.32 Targeted Case Management for HIV Infected Individuals
  • STI Sample Superbill
  • Billing Coding Guide for HIV Prevention
  • NASTAD: Health System Integration
  • Fact Sheet:  The Ryan White HIV/AIDS Program - The Basics​​​​​​
    
  • Time Based Coding
    
  • CMS CDC HRSA Bulletin: Opportunities to Improve HIV Prevention and Care Delivery to Medicaid and CHIP Beneficiaries​​
  • Maryland Minor Consent Laws 10 26 12
  • Maryland Insurance Request for Confidentiality - 2017
  • Ryan White Program
    • Ryan White Funded HIV/AIDS Services Program
      
    • Ryan White Program Overview Facts
      
    • Ryan White Program Admin Facts
      
    • Fact Sheet: The Ryan White HIV/AIDS Program - The Basics
      
    • Ryan​ White Legislation - Title XXVI HIV Health Care Services Program
    • Ryan White Program Admin Facts - 2016
    • Ryan White HIV/AIDS Program Legislation - HIV/AIDS Bureau 2016​
      
• Immunizations​
  • COVID-19 New Adminstration Code for Pfizer Pediatric Vaccine Booster Dose​
    
  • Pediatric/VFC Vaccine NDC List
    
  • Sanofi Pasteur Product Coding​
    
  • Billing for Vaccines for Children Program
    
  • COVID ImmuNet COVID-19 Vaccine Registration Order Guide
    
  • Flu 2021-2022 Reference Chart
    
  • Billing Immunization Services
    
  • AAPC 2021-2022 Influenza Vaccine Codes and Pricing
    
  • NDC Crosswalk Tables
    
  • Coding for Pediatric Preventive Care
    
  • Pediatric Coding Table - Commonly Administered Pediatric Vaccines
    
  • Pediatric Influenza Vaccine List
    
  • Adult vaccine and NDC List
    
  • Pediatric/VFC Vaccine NDC List
    
  • Medicare Immunization Factsheet
    
  • Medicare Vaccine Coverage Part B vs. Part D
    
  • Vaccine Administration Patients over 19 & Non VFC
    
  • Immunization CPT Look-Up
    
  • IZ Admin Elsewhere in LHD 25 Mod
    
  • IZ Overview Chart
    
  • ​Immunization (IZ) Services Billing Guide
  • ​​Coding for Vaccine Administration
    
  • Immunization Coding for OB-GYN 2019
  • ​IZ Admin Elsewhere in LHD
    
  • ​Standing Orders for Immunization
    
  • Using Standard Orders for Administering Vaccines: What You Should Know
  • ​Vaccines for Children (VFC) Program
    
  • • Pediatric/VFC Vaccine NDC List
      
    • VFC Provider Responsibility to Screen for VFC Patients
      
    • Pediatric/VFC Vaccine NDC List
      
    • Pediatric Influenza Vaccine List
      
    • Vaccine Information Sheets - Required Use​
    • VFC Eligibility Criteria
      
    • VFC Patient Eligibility Screening Record
    • VFC - CDC Info at a Glance
    • ​​VFC MA List - January 2019
      
    • ​Pediatric Coding - Commonly Administered Pediatric Vaccines
      
    • VFC SE Mod on CMS Claim
      
    • ​How Medicaid and VFC Work Together​
      
  • Medicare Immunization Services
    • Medicare Part D Vaccines and Vaccine Administration
      
    • Medicare Coverage: Parts B & D
      
    • Medicare Part B Immunization Billing​
      
• Nutrition Program​
  • Nutrition and Diabetes Prevention Programs​
• PrEP Services
  • PrEP Billing FAQs
    
  • CDC Paying for PrEP
    
  • PrEP Guidelines
    
  • PrEP 101 Consumer Information
  • PrEP Flow Chart
    
  • Maryland Minor Consent Laws 10 26 12
    
• Rabies
  • Rabies COMAR Regulations​​
    
• Refugee Services
  
  • Reimbursement and Billing FAQ Refugee Services
    
  • The Maryland Refugee Health Program
    
  • Overseas Health Guidance Immigrant and Refugee Health CDC​
    
  • Refugee Coding Guide
    
  • Refugee Services Coding Guide
  • Maryland Immigrant & Refugee Information System (MIRIS) User Guide - Final Updated March 2016​
• ​​Reproductive Health/Family Planning
  • Title X Job Aid FPNTC Copay Job Aid
    
  • Title X Developing Sliding Fee Schedule FPNTC
    
  • Expedited Partner Therapy
    
  • Family Planning Revenue Cycle Assessment Tool
  • ​Title X 101 Fact Sheet​
    
  • Family Planning Coding Frequently Asked  Questions Title X
  • Maryland Medicaid Family Planning Program
  • LARC Quick Coding Quide-Contraceptive  Implant and IUDs
  • ICD-10 Code Look-up for Reproductive Health​
  • NFRHA Online Training Tool
  • 340B Family Planning Policy Procedure Manual (Sample)
  • Detailed Overview - 340B Health​
  • 340B Family Planning Guide​
  • FPNTC Covid 19 Social Media Toolkit for Family  Planning Providers
  • Reproductive Health Title X Compliance  Resources​​​​
    
  • Title X Wins Final
    
  • Ensuring Access to Equitable Affordable Client Centered
  • Comparison of 2019 and 2021 Final Title X Rules
  • Maryland Title X Facts 2020-3 MD
  • Title X Ensuring Access to Equitable, Affordable, Client Centered Family Planning​​​
    
  • 2020 Title X Job Aid FPNTC Copay Job Aid
  • Verifying Patient Income Title X
  • Family Planning NACHC
  • Family Planning Information Altarum Title X
  • Title X Developing Sliding Fee Schedule FPNTC
  • Title X and Health Center Program Sliding Fee Discount Schedules​
  • Expedited Partner Therapy​​
  • Family Planning Workbook
  • Family Planning Revenue Cycle Assessment Tool
  • Impact of the Title X Rule in Maryland
  • Title X 101 Fall 2020
  • Title X Verifying Patient Income
  • FPNTC Financial Management Change May 2020
    
  • FPNTC Title X Telehealth Staffing Steps Outline 8.21.20
  • Women's Preventive Services Guidelines - 2016​​​​​​
  • FPNTC Family Planning and Related Health Services for Women Checklist
  • FPNTC Family Planning and Related Health Services for Men Checklist
  • Maryland Medicaid Program Reproductive Health Services Overview
  • Maryland Title X Family Planning and Reproductive Health Program Information - 2017
    
  • Maryland Medicaid Family Planning Program​
  • ICD-10 Palm Card - Updated 3-13-19
    
  • NFRHA Superbill Example​​
    
  • LARC Quick Coding Guide - Contraceptive Implant and IUDs
  • Family Planning Chart - What Makes a FP Patient
    
  • ICD-10 Code Look-Up for Reproductive Health​
  • NFRHA Online Training Tool
    
  • Request for Confidential Communications Form
  • 340B Family Planning Policy Procedure Manual​
  • 340B Compliance Self-Assessment Policy
  • 340B Drug Pricing Program Infographic
  • Cardea: A Coding Guide for Programs and Providers​
  • FPNTC COVID-19 Social Media Toolkit for Family Planning Providers
    
  • FPNTC Collecting Co-Pays and Applying Sliding Fee Discount Schedule Job Aid
    
  • Challenges to Patient Confidentiality Infographic​
  • Maryland Family Planning and Reproductive Health Program Administrative Guidelines - 2015
    
  • How to Credential Family Planning Providers with Health Plans
  • Maryland Minor Consent Laws 10 26 12​
  • Reproductive Health Title X Compliance Resources
  • WPSI - Well Woman Chart FAQs​
  • WPSI - Well Woman Chart​​
  • Title X
    • Title X Job Aid FPNTC Copay Job Aid ​
      
    • Title X Developing Sliding Fee Schedule FPNTC
    • Family Planning Coding Frequently Asked  Questions Title X
      
    • 50 Years of Title X: A Timeline of Key Events​
    • Reproductive Health Title X Compliance Resources
      
    • Integrating Title X with Primary Care: Developing and Implementing Compliant Sliding Fee Discount Schedules
    • Collecting Copays and Applying A Sliding Fee Discount Schedule
    • Title X Fact Sheet
    • Family Planning Coding Frequently Asked  Questions Title X​​​​
      
    • OPA ​Program Requirements for Title X Funded Family Planning Projects
      
    • Verifying Patient Income in a Title X Setting
      
    • Maryland Family Planning and Reproductive Health Program Administrative Guidelines​ - 2015​​​
    • CDC and OPA 2017 Recommendations Providing Quality Family Planning Services
    • Title X Federal Register - March 2019
    • Billing and Coding Manual for Title X Family Planning Clinics

    • HHS Title X 2019 Guidance: Frequently Asked Questions​
      

    •  

      Reproductive Health Title X Compliance Resources
    • Title X Charges, Billing and Collections Guidelines
    • Maryland State Family Planning Title X Program Review Tool
    • FPNTC Collecting Co-Pays and Applying Sliding Fee Discount Schedule Job Aid
• ​​SBIRT
  
  • SBIRT Factsheet Medicare​
    
  • SBIRT Coding​​
    
  • ​Amerigroup SBIRT​
    
  • SBIRT Factsheet Medicare March 2020​​​​​
  • Medicaid Program Updates - Spring 2016​
    
  • SBIRT Coding - 2017
  • SBIRT: A Step-by-Step Guide
    
  • SBIRT Fact Sheet
  • Substance Use Disorder Self-Referral​ Manual
  • Amerigroup SBIRT Flier
  • SBIRT SAMHSA January 2020
    
  • SBIRT Rack Card Final 1-12-16​
    
  • SBIRT Brochure
  • SBIRT Poster
• ​​School Based Health Centers (SBHC)
  
  • SBHC Contact List
    
  • Commonly Administered Pediatric Vaccines
    
  • Pediatric/VFC Vaccine NDC List
    
  • SBHC Telehealth Consent Form
    
  • SBHC Telehealth Checklist​​​
    
  • School-Based Health Center Provider Manual​
    
  • Maryland Medicaid School-Basaed Health Center Provider Manual September 2020
  • COVID-19 Telehealth Guidance for School-Based Health Centers
  • ​SBHC Medicaid Billing Review 9.14.2020
    
  • SBHC LEAHP Telehealth Schools Webinar Shifting Policy Practice Landscape 6.11.2020
  • SBHC LEAHP Telehealth Post-training webinar handout 6.15.2020​
    
  • ​2019 AAP - Coding for Pediatric Preventive Care
  • SBHC Sample Superbill - 2017
  • Time Based Coding
  • SBHC Contact List - FY 2020
  • SBHC Introduction to Billing and Coding
    
  • Pediatric Coding - Commonly Administered Pediatric Vaccines
  • Pediatric/VFC Vaccine NDC List 2019
  • SBHC Visit Report Form
  • What are School-Based Health Centers (SBHCs) or School-Based Wellness Centers?
    
  • Maryland Minor Consent Laws 10 26 12​
• STI
  • NCSD STD and HIV Programs Funding Chart FY22​
    
  • 340B Basics and Beyond NCSD
    
  • Medicare Coverage for STI Services
    
  • Maryland EPT Statute
    
  • STI Billing FAQ​
    
  • STI BH Counseling for Prevention USPSTF 8.2020
  • STI Billing FAQs​
    
  • Time Based Coding​​​
    
  • STI Contact Tracing Infographic
  • Medicare Coverage for STI Services​
    
  • EPT Fact Sheet for Health Care Providers FINAL as of 3.19.19
    
  • Maryland EPT Statute 
  • Maryland EPT Provider Guide​
  • 340B Drug Pricing Program Infographic​
    
  • STI Tool​​​
  • Confidentiality
    • National Family Practice Title X Confidential and Covered
    • Maryland Insurance Request for Confidentiality - 2017
    • MD Confidentiality Law 2014 Ch. 72 sb0790T
      
    • Request for Confidential Communications Form
    • Confidentiality Issues STI 15-25 yrs.​ mm6609
      
    • AAP Adolescent Confidentiality​ ​​​
    • Maryland Minor Consent Laws 10 26 12​
• Telehealth​
  • MM12427 Matters New Modifications to the POS for Telehealth​
    
  • JHHC Reimbursement Policy update Telehealth Telemedicine​
    
  • Plan your Telehealth Workflow
    
  • Title X Telehealth Visit Workflow Job Aid​
    
  • Maryland Health Care Commission: Telehealth
    
  • Billing for Telehealth Program Manual-Updated
    
  • Maryland Medicaid Telehealth Program FAQ Updated
    
  • CMS Telehealth Codes Updated January 2022
    
  • School Based Health Center Telehealth Checklist​​
  • ​HIT Payer Coverage Billing Expansion COVID-19
    
  • CMS MM12549 CY2022 Telehealth Updates
    
  • CMS Telehealth  POS MNL MM12427
  • Telehealth Payer Billing Guide Revised 12.1.2021
  • CMS 2022 Medicare Physician Fee Schedule Updates for Telehealth Final Rule MM12519
  • MLN New Modification of POS Codes for Telehealth
  • JHHC Priority Partners Guidance on the Continuation of Telehealth
  • UHC Community Plan Telehealth and Telemedicine Policy​​​​​​​
    
  • FINAL BHA Telehealth Post Emergency Revised​
    
  • Telehealth Center for Connected Health Policy Telehealth 2021 Billing Guide
  • UHC Telehealth and Telemedicine Policy
  • Telehealth Payer Billing Guide Revised 4.10.21
  • UHC Telehealth Services Preventive Medicine ABA Codes
  • UHC Telehealth Patient Scenarios 2021​
    
  • AMA: Telehealth Implementation Playbook
    
  • Billing for Telehealth Encounters: An Introductory Guide on Fee-for-Service​​
    
  • Telehealth MDH COMAR 10.09.49 October 2019
    
  • School-Based Health Center Telehealth Checklist - FY 2020
• Tuberculosis (TB)​
  • TB Services and Reimbursement Barriers
    
  • ​TB Test Coding
    
  • Maryland Local Health Department TB Program Phone Directory​​
  • PPD Medicare Billing​​
    

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