CurrentNeighborhood Health Plan of Rhode IslandPolicy N/A

Billing and Reimbursement Guideline: Special Services, Procedures and Reports

Defines Neighborhood Health Plan of Rhode Island's reimbursement stance for selected CPT 99000–99091 codes and related special services, applying to all places of service and claim types for providers submitting to Neighborhood.

Policy Summary

PayerNeighborhood Health Plan of Rhode Island

PolicyBilling and Reimbursement Guideline: Special Services, Procedures and Reports

Policy CodePolicy N/A

Change TypeFormat change only (9/1/13)

Effective DateSep 1, 2010

Next Review DateN/A

Key ActionSubmit codes 99000–99091 bundled with the associated basic service; bill 99070 on paper with invoice only if contract permits and supply is FDA-approved.

SourceLink

POLICY UPDATE CHANGES

Format change only noted on 9/1/13.

99000-99091range addressed as always billed with basic service / not separately reimbursable

99000-99002handling and conveyance charges bundled / not payable when specimen referred or transferred

99070not reimbursed unless contractually specified; requires paper claim, invoice, FDA approval

All claims/formsApplies to

Reimbursement criteria for special services and reports

Coverage determination for listed codes:

Codes 99000-99091 are always billed in conjunction with the basic service provided for the patient and are not separately reimbursable.

ALL of the following

Codes 99000-99002: Handling and conveyance charges are bundled; routine handling charges are not payable when a specimen is referred from one lab to another or when a physician's lab transfers a specimen to a reference laboratory; these charges are considered part of the office visit.

ALL of the following

Code 99024: Postoperative follow-up visits are included in the surgical global package and are not separately reimbursable when billed as part of surgical care.

ALL of the following

Policy Summary

PayerNeighborhood Health Plan of Rhode Island

PolicyBilling and Reimbursement Guideline: Special Services, Procedures and Reports

Policy CodePolicy N/A

Change TypeFormat change only (9/1/13)

Effective DateSep 1, 2010

Next Review DateN/A

Key ActionSubmit codes 99000–99091 bundled with the associated basic service; bill 99070 on paper with invoice only if contract permits and supply is FDA-approved.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

99000-series bundling and code handling

99000-99091CPTNot Covered

99000-99091

Special services and reports — bundled with basic service; not separately reimbursable.

Handling and conveyance chargesCPTNot Covered

99000-99002

Handling and conveyance charges — bundled; not payable when specimen referred/transferred.

Postoperative follow-upCPTNot Covered

99024

Postoperative follow-up included in global surgical package; not separately reimbursable.

On-call servicesCPTNot Covered

99026-99027

Hospital-mandated on-call services — not reimbursable.

Emergency office servicesCPTNot Covered

99058

Emergency services in office in addition to basic services — not separately reimbursable.

Supplies — miscellaneousCPTNot Covered

99070

Supplies — not reimbursed unless contract specifies; if miscellaneous must be billed on paper with invoice; only FDA-approved supplies reimbursable; invoice within one year required.

Educational suppliesCPTNot Covered

99071

Educational supplies bundled into office visit — not separately reimbursable.

Medical testimony and reportsCPTNot Covered

99075	Medical testimony and special reports — not separately reimbursable.
99080	Medical testimony and special reports — not separately reimbursable.

Physician group educationCPTNot Covered

99078

Physician group educational services to patients — not separately reimbursable.

Unusual travel/escortCPTNot Covered

99082

Unusual travel, transport and escort of patient — not reimbursable.

Computerized data analysis/interpretationCPTNot Covered

99090-99091

Analysis/interpretation of computerized clinical data — bundled; not separately reimbursable.

Provider billing guidance for CPT 99000–99091

Billing Rule

Bill 99000–99091 as bundled; special rules for 99070

These codes (CPT 99000–99091) are considered bundled with the basic service and are not separately reimbursable. For code 99070, Neighborhood does not reimburse it unless the contract specifically allows it; when treated as a miscellaneous supply it must be billed on paper with a miscellaneous supply code and an invoice attached, only FDA‑approved supplies/devices are reimbursable, and invoices older than one year from the date of service will not be accepted.

CPT codes 99000–99091 are always billed with the basic service and are not separately reimbursable.
Handling/conveyance charges (99000–99002) are bundled and not payable when a specimen is referred or transferred.
99070 is not reimbursed unless contractually specified; if miscellaneous, submit a paper claim with a miscellaneous supply code and invoice; only FDA‑approved supplies reimbursable; invoices >1 year old will be denied.

Key definitions

inv-04: Bundled service — definition and explanation

DefinitionA bundled service is a procedure or supply considered part of another service (for example, an office visit or the global surgical package) and is not separately reimbursable.

ScopeCodes 99000-99091 are always billed in conjunction with the basic service and are not separately reimbursable by Neighborhood Health Plan of Rhode Island.

Examples99024 (postoperative follow-up) is included in the surgical global package and not separately reimbursable; 99058 (office emergency services) and 99071 (educational supplies) are bundled with the basic service.

Excluded chargesHandling and conveyance charges (99000-99002) are bundled and not payable when a specimen is referred or transferred between labs or to a reference laboratory.

Analysis services99090-99091 (analysis/interpretation of computerized clinical data) are considered bundled and not separately reimbursable.

inv-05: Miscellaneous supply billing — paper claim, invoice timing, FDA approval requirements

When requiredIf a supply is considered miscellaneous (99070), Neighborhood does not reimburse unless contractually specified; reimbursement requires special billing and documentation.

Claim formMiscellaneous supplies must be billed on paper (paper claim) with a miscellaneous supply code and an invoice attached for review.

Invoice timingNo invoice older than one year from the date of service billed will be accepted; invoice must be within one year.

FDA requirementOnly supplies and devices that are FDA approved are reimbursable; non–FDA approved supplies/devices will be denied.

Related codeCode 99070 governs miscellaneous supplies; 99071 (educational supplies) is bundled and not separately reimbursable.