UHC Community Plan of New Jersey has announced they will be adding CPT codes that are billed by physical therapists, occupational therapists and speech-language pathologists to their list of codes that require Advance Notification and Prior Authorization. To access the revised list, click I hope you found this information helpful. Thank you for being a Gold Member!

Aetna has announced they will reactivate edits when a CPT code on the claim form contains billing modifiers 25, 59 or X series (XE, XP, XS, XU). This reactivation will apply to the states of I hope you found this article helpful. Thank you for being a Gold Member!

New Jersey Governor Murphy announces Departmental Actions to Expand Access to Telehealth and Tele-Mental Health Services in Response to COVID-19. This includes physical therapists, occupational therapists and speech-language pathologists. Click HERE to read the announcement.

UnitedHealthcare (UHC) Community Plan is adding 3 states (in addition to the 4 previously announced) that will require prior authorization prior to initiating physical, occupational and/or speech therapy services. In addition, UHC Community Plan is adding site of service medical necessity reviews for all speech, occupational and physical therapy services provided in a hospital outpatient setting in 2 of the 3 states. The new impacted states are

UnitedHealthcare Community Plan has announced they will implement prior authorization for outpatient physical, occupational and speech therapy services in select states beginning as early with dates of service on and after August 1, 2019. In addition, UnitedHealthcare Community Plan has announced they will be conducting site of service medical necessity reviews for all speech, occupational and physical therapy services in select states. Effective with dates of service on and after August 1, 2019, the following states will be required to obtain prior authorization before implementing outpatient physical, occupational and/or speech therapy services: