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Quality Program
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Pharmacy
Clinical Policies
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Risk Adjustment: Continuity of Care Program
Tailored Plans
Tobacco-Free Policy Resources
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Transportation Services
Home Health and Personal Care Services
In Lieu of Services (ILOS)
Healthy Opportunities
Payment Policies
*Note:
Tailored Plan Physical Health providers are subject to Payment Policies for Carolina Complete Health below. Behavioral Health (BH) Tailored Plan providers should defer to the Tailored Plan for policy information for BH services.
Intravenous Hydration, CC.PP.012 (PDF)
Maximum Units of Service, CC.PP.007 (PDF)
Non-obstetrical and Obstetrical Transabdominal and Transvaginal Ultrasounds, CC.PP.061 (PDF)
Please refer to
PHP Billing Guidance
section 3.4.4 specific to Institutional Claims
Robotic Surgery, CC.PP.050 (PDF)
Sepsis Diagnosis, CC.PP.073 (PDF)
- latest revision effective date 03/26/24
Sleep Studies Place of Service, CC.PP.035 (PDF)
Unbundled Professional Services, CC.PP.043 (PDF)
Unbundled Surgical Procedures, CC.PP.045 (PDF)
Urine Specimen Validity Testing, CC.PP.056 (PDF)
Optum Comprehensive Payment Integrity (CPI), CC.PP.074 (PDF)
