Posted in Insurance, Payers and CPT reinbursement, Training

UnitedHealthCare COVID-19 Physical , Occupational and Speech Therapies Telehealth Coverage- update 04/20/2020

As of 04/20/2020 UHC announce that it will cover PT, OT and ST services for its members. enrolled in Medicare Advantage, Medicaid, Individual, and Fully Insured Group Market Plans.

This applies to services performed between 03/18/2020 and 06/18/2020

Q.Covered Services?

A. The services have to rendered using interactive live audio-visual technology. During the live video conferencing both parties must be present- patient and the provider.

Q. What is NOT covered?

A. E-mailing “stored” exercise videos to the patient and using a phone to review or discuss them with the patient.  

The providers have to be certified in the given state, where they are providing the service.

Cost sharing will be waived for the services performed by IN-Network providers only. There is an Opt-in option for self funded employers.

Billing & Coding:  Applies to all lines of business.

The complete list of acceptable/reimbursable CPT codes could be found by clicking HERE.

Services that are billed on HCFA 1500 form with modifier 95 with a Place of Services where the services would be furnished in person.

Services that are billed on UB04 should be billed with revenue code 780.

Utilization Management:

There is no change to the utilization management requirements for PT, OT, ST.

Please remember that the claims will be processed based on UHC member’s benefits plan.

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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