Applies to Medicaid Expansion only
Blue Cross Blue Shield of North Dakota (BCBSND) Medicaid Expansion is informing providers of the BCBSND recognition and use of modifier AF starting Dec.1, 2024. Review the following coding and reimbursement policy Evaluation and Management (E/M) Policy.
The policy has been updated with the following information:
E/M and Behavioral Health
All Medicaid Expansion claims submitted under this policy’s section will be processed according to the policy effective date and associated revision effective dates in effect on the date of service, regardless of service date.
AF Modifier Use
Physicians and Qualified Health Professionals (QHPs) billing office or outpatient office visit E/M’s, 99202-99215, for Behavioral Health diagnosis must append modifier AF to receive the Behavioral Health fee schedule amount.
Modifier AF does not need to be reported on any other E/M Behavioral Health diagnosis. For example: Emergency Room, Observation, Inpatient, etc.
Appending modifier AF to E/M’s outside of 99202-99215 will not have an impact on provider reimbursement.
Questions?
Contact our Medicaid Expansion Provider Service Center at 1-833-777-5779.
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