CommercialReimbursementMedium impact
Coding and Reimbursement Policy Update
Blue Cross Blue Shield of North Dakota·ND · Psychiatry·Coding
Effective date
Jan 29, 2026
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of North Dakota updated their Psychiatric and Substance Use Services Guidelines to prohibit reimbursement for the date of discharge at Residential Treatment Center (RTC) level of care. Providers must still report the true discharge date in the through date section of UB-04 forms but cannot bill for services on that specific date at the line level.
Action Required
Immediately: Billing team must update RTC discharge billing procedures to exclude the actual discharge date from line-level billing on UB-04 claims. Staff should continue entering true discharge dates in the through date section but remove any charges for services provided on discharge day at RTC level. If discharge day services meet PHP or IOP criteria, bill those separately on outpatient claims. Review HealthCare News article on type of bill and patient status for Medicaid Expansion claims.