Effective of 01/01/2021– UHC will change its Telehealth/Telemedicine Policy
This policy will apply to Oxford Plans as well
The following is the reimbursement policy for Telehealth/Telemedicine services:
-The only POS (place of service) that will be allowed is 02 (UHC: this is consistent with the Centers for Medicare and Medicaid (CMS) billing and reimbursement guidelines.)
-Modifiers 95, GT or G0 may be appended to telehealth claims reported with POS 2, BUT will not necessary be used to identify the telehealth services instead they are considered informational.
-UHC will consider the home of the member as an originating site for eligible services
| – Various codes will be eligible for consideration under the policy including the code list listed in the current policy, as well as similar types of services rendered using interactive audio and video technology. (Please see the partial tables below) |
-Certain physical, occupational and speech therapy (PT/OT/ST) telehealth services will be considered for reimbursement when performed by a qualified health care professionals and using interactive audio and video technology.
– The policy addresses additional ways of provider-patient communications including E-visits, remote patient monitoring (non-face-to-face, patient initiated communications, like online portals)
– Payment will align with applicable state law.
Source: (UHC October provider bulletin)