The Washington state legislature recently passed a bill that will change Apple Health’s policies for mental health evaluations for children from birth to age 5, now known as the Mental Health Assessment for Young Children (MHAYC).
Changes under the new MHAYC policy include:
Reimbursement for up to 5 sessions
Reimbursement to health care professional travel costs for assessments performed in home or community settings
Requirement to use the DC:05 diagnostic classification system
Travel reimbursement details
Travel for in-network health care professionals will be reimbursed in accordance with your contract if these qualifications are met:
Conducting a mental health assessment
CPT codes 90791, 90792 or H0031
For a child from birth to age 5 up until their 6th birthday
For a session performed in the child or family’s home or in a community setting
Submit invoices to firstname.lastname@example.org. The invoices will be confirmed to claims based on the eligibility requirements for reimbursed outlined here. If all requirements are not met, UnitedHealthcare can’t adjudicate the claim.
Please submit the invoices no later than 60 days from an adjudicated supporting claim.