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Provider Resources

March 2022 


Table of Contents

CPT and HCPS Code Updates
Current Clinical Practice Guideline for Adult Depression


CPT and HCPS Code Updates

Every quarter the American Medical Association (AMA) updates Current Procedural Terminology (CPT) codes and the Centers for Medicare & Medicaid Services (CMS) updates Healthcare Common Procedure Coding System (HCPCS) codes. 

New codes requiring prior authorization and these services fall within our current authorization, experimental and/or genetic review processes. You can find a list of all services requiring prior authorization here.  

If you have specific questions regarding a service, please contact our member experience or health management teams for assistance. For more information about authorization requirements, forms or services that require review under the experimental and/or genetic process, go to the Authorization Lists by Code on our website. 

Please forward this information to others at your organization who need to follow these processes. For prior authorization requests or questions, contact our population health department at 920-720-1602 or 866-709-0019 Monday–Friday 8 a.m. to 5 p.m. 

Language assistance is available for members or practitioners to discuss utilization management issues. Network Health also offers TDD/TTY services for deaf, hard of hearing or speech-impaired individuals by calling 800-947-3529. All callers may leave a message 24 hours a day, seven days a week. 

Current Clinical Practice Guideline for Adult Depression

The Department of Veterans Affairs/ Department of Defense (VA/DoD) Clinical Practice Guideline for the Management of Major Depressive Disorder version three, developed in April 2016, was adopted by Network Health in 2018.

The VA/DoD guideline has been reviewed and approved for continued use in February 2022 and remains the most up-to-date, thorough and complete U.S. based guideline for treatment of major depressive disorder.

Although developed for the VA patient population, this guideline is applicable to the population with major depressive disorder seen by Network Health contracted providers.
The guideline does not provide recommendations for management of major depressive disorder in children or adolescents.

The target audience of the VA/DoD guideline includes primary care providers, psychologists/non-physician behavioral health clinicians and social workers.

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