Covered and Noncovered Services : Codes

Place of Service Codes

Allowable POS codes for the outpatient mental health benefit are listed in the following table. Note that not all of the POS codes listed in this table are allowable for each procedure code allowed in the outpatient mental health benefit. Providers are required to use the POS code that most accurately describes the place where the service(s) were rendered.

For services provided to members under 21 years of age outside of an office setting, providers are required to document the therapeutic reasons for using an alternative location to support the member's recovery

The outpatient mental health benefit does not include services provided in the home or community settings for members age 21 and over. See the Outpatient Mental Health and Substance Abuse Services in the Home or Community for Adults service area for outpatient services covered in the home or community.