Effective Date:

a)    This policy will apply to all services performed on or after the above revision date which will become the new effective date.

b)    For all services referred to in this policy that were performed before the revision date, contact customer service for the rules that would apply.

Hypnosis, hypnotherapy and meditation therapy may or may not be covered, depending on your specific benefit plan.  Please check your plan documents.  When covered, this type of service 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.

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 contract.

See BI273 (Outpatient Therapy for Mental Health and Substance Use Disorders) for clinical policies regarding mental health treatments.

Codes Used In This BI:

 Hypnotherapy is contraindicated under the following conditions:

1)    Uncooperative or hostile patient.

2)    Psychosis.

3)    Significant history of brain trauma or cognitive deficits.

4)    borderline personality disorder, dependent personality disorder.