What insurance policy changes affect HCPCS H0031?

There are 10 tracked policy changes affecting HCPCS H0031, including updates from Priority Health, CareSource, SC Medicaid - SCDHHS. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS H0031?

Payers that have issued tracked updates for HCPCS H0031 include: Priority Health, CareSource, SC Medicaid - SCDHHS, Connecticut Medicaid (HUSKY Health), Indiana Medicaid (IHCP), Harvard Pilgrim Health Care, Arizona Medicaid - AHCCCS, L.A. Care Health Plan.

How do I get notified when HCPCS H0031 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS H0031. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for HCPCS H0031?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

H0031 — Mental health assessment, by non-physician: Insurance Policy Changes

H0031 Insurance Policy Changes

HCPCS H0031 is officially defined as "Mental health assessment, by non-physician." HCPCS H0031 is referenced in 10 tracked payer policy changes from Priority Health, CareSource, and 6 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS H0031 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

Rehabilitative Behavioral Health and Substance Use Services Rate Increases

SC Medicaid - SCDHHS·Effective Dec 1, 2025

South Carolina Medicaid has implemented significant rate increases and billing unit changes for behavioral health and substance use services effective December 1, 2025. Key changes include converting H0002 from 15-minute units to encounters, H0032 from 15-minute to 30-minute encounters, correcting H0038 peer support rates to $14.48, and updating reimbursement rates across multiple procedure codes for RBHS providers, LIPs, and substance use services.

H0031 Insurance Policy Changes

Reimbursement available for Medicaid mental health screening assessments including telehealth

[Georgia] CareSource Policy and Prior Authorization changes

Rehabilitative Behavioral Health and Substance Use Services Rate Increases

2025.57 - October 2025 - Updates to Autism Spectrum Disorder Services

BT202616: IHCP corrects rates for certain MRO services

Applied behavioral analysis policy and coverage updates

DSS Important Message - December 2025 interChange Newsletter

2025.30 - Provider Bulletin - Updates to Autism Spectrum Disorder Services

AHCCCS DFSM Claims Clues - Updated Correction Notice - Updated Guidance on T1016 Code Allowance fora Provider with a Counseling Facility License

Behavioral Health Treatment (BHT) – Applied Behavioral Analysis (ABA) Authorization Request Form

Reimbursement available for Medicaid mental health screening assessments including telehealth

[Georgia] CareSource Policy and Prior Authorization changes

Rehabilitative Behavioral Health and Substance Use Services Rate Increases

2025.57 - October 2025 - Updates to Autism Spectrum Disorder Services

BT202616: IHCP corrects rates for certain MRO services

Applied behavioral analysis policy and coverage updates

***DSS Important Message - December 2025 interChange Newsletter***

2025.30 - Provider Bulletin - Updates to Autism Spectrum Disorder Services

AHCCCS DFSM Claims Clues - Updated Correction Notice - Updated Guidance on T1016 Code Allowance fora Provider with a Counseling Facility License

Behavioral Health Treatment (BHT) – Applied Behavioral Analysis (ABA) Authorization Request Form

DSS Important Message - December 2025 interChange Newsletter