Hypnotherapy or meditation therapy, when covered by the member’s benefit plan,
are considered mental health modalities. As such, they must be prescribed by a
physician for an appropriate mental health diagnosis and provided by a licensed
mental health provider as part of a mental health treatment plan. Other mental
health services/modalities may not be billed at the same time. If hypnotherapy
is provided at the same time as psychotherapy, the claim must show the code for
hypnotherapy or the code for psychotherapy—it cannot include both.
Preauthorization is required beyond 15 visits, as per BI273.
Coverage is limited by the mental health benefits in the specific member
BI273 (Outpatient Therapy for Mental Health and Substance Use Disorders) for
clinical policies regarding mental health treatments.
Used In This BI: