Psychiatry/Behavioral Health policy updates
Track new and updated Psychiatry/Behavioral Health policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| ILOS - Residential Services for Individuals with Complex Needs (Residential Level III) for Children with IDD and Co-occurring Mental Health Diagnoses | Blue Cross Blue Shield - North Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Feb 10, 2026 |
| Behavioral Health Urgent Care (BHUC) ILOS | Blue Cross Blue Shield - North Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Feb 10, 2026 |
| Enhanced Crisis Response (ECR) Rapid Response Team (RRT) — In Lieu of Service (ILOS) | Blue Cross Blue Shield - North Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Feb 10, 2026 |
| Esketamine (Spravato) Nasal Spray Coverage Criteria | Blue Cross Blue Shield - North Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Jan 1, 2026 |
| Geropsychiatric nursing facility units (geropsychiatric units) | Blue Cross Blue Shield - North Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Jan 1, 2025 |
| Opioid Treatment Program (OTP) Service | Blue Cross Blue Shield - North Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Jan 1, 2025 |
| Medically Monitored Inpatient Withdrawal Management (Non-Hospital Medical Detox) | Blue Cross Blue Shield - North Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Dec 31, 2024 |
| Medically Monitored Inpatient Withdrawal Management (Non-Hospital Medical Detox) | Blue Cross Blue Shield - North Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Dec 31, 2024 |
| Medically Monitored Inpatient Withdrawal Management (Non-Hospital Medical Detox) | Blue Cross Blue Shield - North Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Dec 31, 2024 |
| Psychiatric Partial Hospitalization Programs (PHP) — Coverage Criteria | Blue Cross Blue Shield - North Carolina | Clinical | Psychiatry/Behavioral Health | Modified | Jul 1, 2024 |
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
OpenPayer by Trek Health — Policy intelligence for billing and revenue cycle teams.
Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.