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How to bill UHC EAP?

These plans require authorization and will only cover a set amount of visits. They do not require a co-pay. In these cases, you can bill the same as you would a routine visit, but add the EAP modifier code, HJ. After the EAP visits are exhausted, visits will fall under the normal behavioral health insurance umbrella.

What is the modifier for EAP?

The majority of insurance companies require the HJ modifier for EAP visits.

How to bill EAP through Optum?

Use the CPT Code 99404 in order to indicate the sessions is billed under EAP. Both Optum and Cigna require the inclusion of the Authorization number on the claim.

How to bill Optum EAP?

CPT Code 99404 Reimbursement Rate Reimbursement for 99404 by Cigna tends to be similar to routine sessions, like 90834 or 90837. Because all sessions billed as 99404 are EAP, they should not have any patient responsibility.

What is the payer ID for Optum EAP?

The Optum payer ID is 87726. A payer ID is not necessary to submit behavioral health or EAP claims on Provider Express or via paper.

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