As communicated in the December edition of Partners in Health UpdateSM, effective January 1, 2011, changes will be made to the mental health and substance abuse benefits for the Federal Employee Program (FEP). However, the following clarification applies to the residential treatment centers information:
Residential Treatment Centers (RTCs) will no longer be treated as covered providers. Changes will be put in place to discontinue Preferred Mental Health/Substance Abuse benefits for inpatient facility claims submitted by RTCs unless they are provided and approved under the case management process. This applies to both the Standard and Basic Option for claims incurred on or after January 1, 2011, with a type of bill equal to 086X or have a revenue code equal to 1001 or 1002.
If you have any questions regarding these changes, please contact your Network Coordinator.