For some payers, payer routing depends on whether the rendered service qualifies as a behavioral health visit (e.g. Blue Shield of California routes to Magellan for behavioral health visits).
For post appointment payer routing, Candid uses a CPT code list to determine whether the appointment qualifies as a behavioral health visit (see “Inputs: Service Type” in the appendix for list of qualifying CPT codes and behavioral health routing logic). Since CPT codes are not available pre-appointment, the service type input is used to determine whether the appointment is expected to qualify as behavioral health.