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

UnitedHealthcare (UHC) Community plan has revised their Outpatient Speech, Occupational and Physical Therapy Utilization Review Guidelines. QuestionWhat is the effective date of the revised policy? Answer QuestionWhat state(s) does the revised policy apply to? Answer QuestionWhat are some of the topics discussed in the policy? Answer QuestionHow can I access the policy? Answer I hope you found this article informative and helpful. 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 written approval of

UnitedHealthcare (UHC) Community Plan has revised their Speech Language Pathology Services Coverage Determination Guideline. QuestionWhat is the effective date of the revised policy? Answer QuestionWhat state(s) does the revised policy apply to? Answer QuestionWhat are some of the topics discussed in the policy? Answer QuestionHow can I access the revised policy? Answer I hope you found this article informative and helpful. 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 written approval of Gawenda

UnitedHealthcare Community Plan has published 2 Reimbursement Policies, one for providers who submit claims on a 1500-claim form (Professional) and one for providers who submit claims on a UB-04 claim form (Facility). The policies list which CPT codes are and are not covered by the different state’s Medicaid program. To access the policy for providers who submit claims on a 1500-claim form, click To access the policy for providers who submit claims on a UB-04 claim form, click I hope you found this article helpful to your practice or organization. Thank you for being a Gold Member!

UnitedHealthcare (UHC) Community Plan has issued a revised Speech Language Pathology Services Coverage Determination Guideline (CDG). The effective date of this revised CDG is May 1, 2021 and only applies to the states of Arizona, California, Hawaii, Kansas, Maryland, Michigan, New York, Ohio, Pennsylvania, Rhode Island, Virginia, Washington, and Wisconsin. To access the revised policy, click I hope you found this article helpful. Thank you for being a Gold Member.

UnitedHealthcare has announced a major change in what CPT codes will be reimbursed for outpatient physical and occupational therapy services for their UnitedHealthcare Community Plan of New York as well as the following plans in the state of New York: UnitedHealthcare Community Plan for Families (Medicaid) UnitedHealthcare Community Plan Wellness 4 Me (HARP) UnitedHealthcare Community Plan Essential Plan (EP) Products. This update will affect CPT Codes for physical and occupational therapy and for evaluation management. All other CPT codes for physical and occupational therapy services will be considered non-covered. The effective date of the changes for UHC Community Plan of New York is I

UnitedHealthcare (UHC) Community Plan has revised their Cognitive Rehabilitation medical policy for the state of Tennessee with an effective date of June 1, 2020. To access the revised policy, click I hope you found this information helpful. Thank you for being a Gold Member!

UnitedHealthcare Community plan has revised one clinical policy pertaining to cognitive rehabilitation, 3 coverage determination guidelines pertaining to outpatient physical, occupational and speech therapy services and 2 utilization review guidelines pertaining to outpatient physical, occupational and speech therapy services. The following policies have been revised with an effective date of April 1, 2020 except for Cognitive Rehabilitation which became effective March 1, 2020: I hope you found this article informative and will assist you treating and billing UnitedHealthcare Community Plan beneficiaries for dates of service on and after April 1, 2020. Thank you for being a Gold Member!