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.
- Add-on Code Billed w/o Primary Code (PDF)
- 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)