DE HB268

Allows the Director of the Division of Medicaid and Medical Assistance to develop and implement new procedural billing codes for annual behavioral health well checks that are comparable to existing CPT codes (99381-99387, 99391-99397).

Maintains requirement that all carriers provide coverage of annual behavioral health well checks at rates comparable to rates for other medical care, with adjustments for nonphysician clinicians applied no more stringently than for other medical services.

Permits the Director to update the list of billing codes through rules if the cited CPT codes are altered, amended, changed, deleted, or supplemented.

Prohibits carriers from denying reimbursement for CPT codes used for behavioral health well checks based on prior reimbursement of those same codes for other services, and vice versa.

Addresses accuracy of state claims data submitted to the Centers for Medicare and Medicaid Services by allowing use of designated billing codes instead of existing CPT codes.