On March 26, 2020, the Ohio Bureau of Workers’ Compensation announced they will temporarily expand the providers permitted to bill for virtual check in services and telephone services to check in with established patients. Telephone services include CPT codes 99371, 99372 or 99373. The virtual check in service codes include CPT codes 98970, 98971, and 98972. The virtual check-incontact is usually made electronically through a patient portal. For purposes of this temporary policy update, the contact can also be made by email. These code sets are currently billed by providers who can render Evaluation and Management Services. Under Policy Alert

If you submit claims to Anthem Blue Cross, significant changes are occurring beginning with dates of service on and after November 1, 2019. AIM Specialty Health has announced they will relaunch the AIM Rehabilitative program (i.e. prior authorization) for Anthem’s Commercial Membership on November 1, 2019 for the following states: I hope you found this article helpful. Thank you for being a Gold Member!

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:

Effective July 1, 2019, Anthem Blue Cross patients in several states will require preauthorization to receive outpatient physical, occupational and speech therapy services. This will be true not only for new patients beginning therapy on or after July 1, 2019, but also for current Anthem patients who are being seen now and will continue to be seen for therapy on or after July 1, 2019. The states where prior authorization will be required effective for dates of service on and after July 1, 2019 are: