UnitedHealthcare (UHC) Oxford has revised their Multiple Therapy Procedure Reduction (MTPR) reimbursement policy with an effective date of December 1, 2021. In this policy, UHC Oxford lists the practice expense (PE) relative value unit (RVU) of each applicable CPT code so therapy providers will know which CPT code has the highest PE RVU and thereby will know the first unit of that code will not have their PE RVU decreased by 50%. Providers will then know which other CPT codes billed that day will have their PE RVU decreased by 50%. To access the revised policy, click

UnitedHealthcare (UHC) has revised their professional Telehealth/Telemedicine Policy for their UHC Commercial and UHC Oxford 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

UnitedHealthcare (UHC) Oxford has revised their outpatient physical and occupational therapy clinical policy. QuestionWhat is the effective date of the revised policy? Answer QuestionCan you provide a summary of the changes in this revised policy? Answer QuestionAre there CPT codes that can’t be billed by an Occupational Therapist? Answer QuestionAre there any exceptions to this policy? Answer QuestionWhere can I access the revised policy? Answer I hope you found this article helpful to your practice. 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

UnitedHealthcare Oxford has published a new reimbursement policy on National Correct Coding Initiative (NCCI) edits that is applicable for therapy providers who submit claims on a 1500-claim form. The effective date of this new policy is I hope you found this information helpful. Thank you for being a Gold Member!

UnitedHealthcare (UHC) has revised several therapy coverage determination guidelines and medical policies related to their UHC Commercial and Affiliate Plans, UHC Exchange Plans, and UHC Community Plan. Continue reading below to access the revised guidelines and medical policies that are applicable to your state. UHC Commercial Medical Policy Update The following coverage determination guideline has been revised and applies to all 50 states. This Coverage Determination Guideline may also be applied to Medicare Advantage plans in certain instances. In the absence of a Medicare National Coverage Determination (NCD), Local Coverage Determination (LCD), or other Medicare coverage guidance, CMS allows a

UnitedHealthcare (UHC) has announced a commercial reimbursement policy update for outpatient physical, occupational and speech therapy services provided in facility settings. This would include any setting that submits claims to UHC on a UB-04 claim form. This policy update will impact UHC Commercial Plans as well as UHC Oxford Health Plans. The new Outpatient Rehabilitation Therapy Services Policy, Facility will be effective for dates of service on and after I hope you found this information helpful. Thank you for being a Gold Member!

UnitedHealthcare Oxford has revised their outpatient physical and occupational therapy clinical policy with an effective date of October 1, 2020. To access the revised policy, click I hope you found this article helpful. Thank you for being a Gold Member.

UnitedHealthcare Oxford has revised its clinical policy for “Outpatient Physical and Occupational Therapy”. The effective date of this revision is July 1, 2020. This policy applies to all Oxford membership excluding New Jersey Small Plan membership. To access the revised policy, click In addition, UnitedHealthcare Oxford has revised its clinical policy for Physical, Occupational, and Speech Therapy Including Cognitive/Neuropsychological Rehabilitation for New Jersey Small Group Members with an effective date of July 1, 2020. This policy applies to Oxford NJ Small plan membership. To access the revised policy, click I hope you found this information helpful. Thank you for being