What insurance policy changes affect CPT 99408?

There are 9 tracked policy changes affecting CPT 99408, including updates from SC Medicaid - SCDHHS, Connecticut Medicaid (HUSKY Health), Nevada Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

How do I get notified when CPT 99408 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 99408. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 99408?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

99408 — A counseling session focused on substance use screening and assessment lasting 15 to 30 minutes.: Insurance Policy Changes

Q: Which payers have updated policy for CPT 99408?

Payers that have issued tracked updates for CPT 99408 include: SC Medicaid - SCDHHS, Connecticut Medicaid (HUSKY Health), Nevada Medicaid, CareSource, Oregon Health Plan, New Jersey Medicaid.

99408 Insurance Policy Changes

CPT 99408, in plain terms, covers A counseling session focused on substance use screening and assessment lasting 15 to 30 minutes. CPT 99408 is referenced in 9 tracked payer policy changes from SC Medicaid - SCDHHS, Connecticut Medicaid (HUSKY Health), and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 99408 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

Rehabilitative Behavioral Health and Substance Use Services Rate Increases

SC Medicaid - SCDHHS·Effective Dec 1, 2025

South Carolina Medicaid has implemented significant rate increases and billing unit changes for behavioral health and substance use services effective December 1, 2025. Key changes include converting H0002 from 15-minute units to encounters, H0032 from 15-minute to 30-minute encounters, correcting H0038 peer support rates to $14.48, and updating reimbursement rates across multiple procedure codes for RBHS providers, LIPs, and substance use services.

99408 Insurance Policy Changes

Rehabilitative Behavioral Health and Substance Use Services Rate Increases

2025.33 - Provider Bulletin - New Coding & Reimbursement for SBIRT Services

Attention Federally Qualified Health Center (FQHC) Providers: Clarification of Pharmacist Codes Billable for Encounters

[Indiana] Behavioral Health Early Intervention (BHEI) Initiative

[Indiana] Behavioral Health Early Intervention (BHEI) Initiative

Notice of intent – OHA will amend the Medicaid State Plan to increase fee-for-service primary care rates.

Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Primary Care

Coverage for Screening, Brief Intervention and Referral to Treatment pdf

Newsletter Vol. 29, No.10