Posted in Insurance, Training, Updates

UHC NY Medicaid Plans: Physical Therapy and Occupational Therapy code changes

This policy is retroactive as of 12/01/2020.

This policy change affects the following plans:

  • UnitedHealthcare Community Plan for Families (Medicaid)
  • UnitedHealthcare Community Plan Wellness 4 Me (HARP)

The non-covered codes section clarifies and supplements the UnitedHealthcare Community Plan of New York National Outpatient Physical and Occupational Therapy policy. All other CPT codes for physical and occupational therapy services will be considered non-covered.

Please still check the member benefit plan document that may supersede the additional considerations and coverage limitations and exclusions and prior authorization requirements.

Partial PT/OT covered list:

Partial Non-covered codes list:

For the complete list of covered and non-covered PT/OT codes, please click here.

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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