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Payment Reimbursement Policies (PRP)

Attention - Physicians Health Plan (PHP) is now University of Michigan Health Plan (UM Health Plan). Documents published before this change may still have references to the PHP brand.

Current PHP Payment Reimbursement Policies

Advanced Practice Providers and Mid-Level Practitioners

(

PRP-09

)
Effective Date:
6/20/2022

Behavioral Health Facility Services

(

PRP-21

)
Effective Date:
11/1/2023

Bilateral and Multiple Procedures

(

PRP-16

)
Effective Date:
8/1/2023

COVID-19 Testing and Treatment

(

PRP-17

)
Effective Date:
7/21/2023

Drug Testing in Pain Management and Substance Use Disorders Treatment

(

PRP-02

)
Effective Date:
11/1/2023

Drugs and Biologicals

(

PRP-11

)
Effective Date:
12/28/2023

Evaluation and Management Services

(

PRP-18

)
Effective Date:
12/28/2023

Hearing Aids and Services

(

PRP-10

)
Effective Date:
12/6/2021

Hospice Services

(

PRP-04

)
Effective Date:
12/28/2023

Inpatient Only Procedures

(

PRP-22

)
Effective Date:
11/1/2023

Inpatient Rehabilitation (IPR) Facility Services

(

PRP-14

)
Effective Date:
11/15/2023

Medical Record Request Standard

(

PRP-05

)
Effective Date:
11/1/2023

Observation Care Facility Charges

(

PRP-01

)
Effective Date:
12/28/2023

Oral Sleep Apnea Device E0485 E0486

(

PRP-13

)
Effective Date:
4/19/2023

Professional Laboratory Services

(

PRP-19

)
Effective Date:
7/19/2023

Spravato Nasal Spray Esketamine

(

PRP-20

)
Effective Date:
11/1/2023

Sub-Acute Rehabilitation (SAR) Skilled Nursing Facility (SNF) Charges

(

PRP-12

)
Effective Date:
11/15/2023

Telemedicine Services

(

PRP-15

)
Effective Date:
12/28/2023

Unlisted CPT-HCPCS Codes

(

PRP-03

)
Effective Date:
10/16/2023

Unspecified Diagnosis Codes

(

PRP-06

)
Effective Date:
11/1/2023
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