NYSHIP (New York State Health Insurance Program) change in Hyperbaric Oxygen Therapy claim submissions
For dates of service prior to January 1, 2020, Empire considered hyperbaric oxygen therapy claims only if billed in conjunction with a qualifying service such as emergency care or surgery service and United Health Care (UHC), NYSHIP’s medical benefit administrator, considered the claims when it was the sole service or billed without a qualifying service.
This only applies to hyperbaric oxygen claims in the outpatient hospital setting. All claims will still be subject to standard medical necessity guidelines.
January 2020 Empire Provider News