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05/06/24

UnitedHealthcare Introduces a Diagnosis Code Requirement Policy

UnitedHealthcare (UHC)has introduced a comprehensive diagnosis code requirement policy for both professional and facility services. This new policy will combine 3 existing diagnosis policies into this new comprehensive diagnosis policy. The effective date of the new policy is To access this new policy as it applies to UHC Medicare Advantage, click To access this new policy as it applies to UHC Community Plans, click To access this new policy as it applies to UHC Individual Exchange Plans, click

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05/01/23

UHC Medicare Advantage June 2023 Reimbursement Update

UnitedHealthcare (UHC) Medicare Advantage has a new reimbursement policy that could have an impact on outpatient therapy claims billed on a 1500-claim form as well as the UB-04 claim form. In this article, I will provide the answers to the following questions:

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08/15/22

UnitedHealthcare Medicare Advantage August 2022 Coverage Summary Update

UnitedHealthcare Medicare Advantage has updated their coverage summary for speech generating devices. To access the updated coverage summary for speech generating devices, click

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06/01/22

UnitedHealthcare Medicare Advantage Updates Therapy Coverage Policy

UnitedHealthcare (UHC) Medicare Advantage has updated their OT, PT, and ST Coverage Policy. The effective date of the updated coverage policy is May 4, 2022. To access the updated policy, click

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01/03/22

UnitedHealthcare Medicare Advantage to Reduce Payment When Services Provided by an Assistant

UnitedHealthcare (UHC) has announced they will reduce payment when services are provided in whole or in part by a physical therapist assistant or an occupational therapy assistant to UHC Medicare Advantage beneficiaries. In this article, I will answer the following questions: When is the effective date of the payment reduction? What is the payment reduction? Will this payment reduction apply to outpatient therapy claims submitted on a 1500-claim form? Does this policy apply to out-of-network (OON) providers? Will this payment reduction apply to outpatient therapy claims submitted on a UB-04 claim form? Does this policy apply to UnitedHealthcare Commercial plans?

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12/06/21

UnitedHealthcare Medicare Advantage Revises Their Telehealth Policy

UnitedHealthcare (UHC) has revised their professional Telehealth/Telemedicine Policy for their UHC Medicare Advantage plans. The effective date for the revised policy is January 1, 2022. This revised policy will not only discuss Place of Service (POS) code 02, but also the new POS code 10 that becomes effective January 1, 2022. To access this information, click I hope you found this article to be informative. Thank you for being a Gold Member! All material posted on our website is intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without prior

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