{"data":{"id":"us-ky/krs-304.17a-662","jurisdiction":"us-ky","citation":"KRS 304.17A-662","heading":"Reimbursement for health benefits delivered through psychiatric","body":"collaborative care model -- Exception.\n(1) (a) As used in this section, \"psychiatric collaborative care model\":\n1. Means the evidence-based, integrated behavioral health serv ice delivery\nmethod described in 81 Fed. Reg. 80230 (November 15, 2016); and\n2. Includes services that are billed under:\na. Except as provided in paragraph (b) of this subsection, the\nfollowing Current Procedural Terminology billing codes\nmaintained by the American Medical Association:\ni. 99492;\nii. 99493; and\niii. 99494; and\nb. Any other Current Procedural Terminology billing codes\nmaintained by the American Medical Association that are used for\nthe evidence -based, integrated behavioral health service delivery\nmethod described in 81 Fed. Reg. 80230 (November 15, 2016).\n(b) The commissioner shall promulgate and maintain an administrative regulation\nin accordance with KRS Chapter 13A that lists any:\n1. Alterations to the billing codes set forth in paragraph (a)2.a. of this\nsubsection; and\n2. Other billing codes that satisfy the requ irements of paragraph (a)2.b. of\nthis subsection.\n(2) Except as provided in subsection (3) of this section, all health benefit plans that\nprovide coverage for treatment of a mental health condition shall provide\nreimbursement for those benefits that are de livered through the psychiatric\ncollaborative care model.\n(3) An insurer may deny reimbursement under a health benefit plan that provides\ncoverage for treatment of a mental health condition for any benefit billed under a\nbilling code referenced in subsecti on (1)(a)2. of this section on the grounds of\nmedical necessity, if the medical necessity determination is:\n(a) In compliance with the Paul Wellstone and Pete Domenici Mental Health\nParity and Addiction Equity Act of 2008, codified at 42 U.S.C. sec. 300gg-26,\nas amended, and any related federal regulations, as amended; and\n(b) Made in accordance with any applicable utilization review requirements set\nforth in this subtitle, including but not limited to KRS 304.17A -600 to\n304.17A-633.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=57594","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:48Z","sha256":"d740deac61d97b1a030b8632b3e337494fad6549f84b9034a7ae6df09a0ff1a1","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-661","next":"us-ky/krs-304.17a-665"},"notice":"GroundRules: Original legal text. Not legal advice."}