Since January 1, 2019, facilities that provide post-acute care inpatient services have been required to request prior authorization and receive a pre-service determination before UnitedHealthcare (UHC) Medicare Advantage Plan members can be admitted to a post-acute care facility or a post-acute care bed in one of the following types of facilities: Acute Inpatient Rehabilitation Skilled…
UnitedHealthcare (UHC) has announced they have delayed the implementation of therapy specific modifiers (GN, GO, GP) to allow providers more time to adjust to changes in the submission of “Always Therapy” procedure codes to include the CMS required therapy modifiers. UHC has provided no new effective date at this time. This requirements was supposed to…
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…
UnitedHealthcare Community Plan has issued a revised coverage determination guideline for outpatient physical and occupational therapy. This policy applies to the following 12 states:
For dates of service on and after July 1, 2019, the Centers for Medicare and Medicaid Services (CMS), as well as UnitedHealthcare (UHC), is changing which CPT code Modifier 59 must be appended to on the claim form in order for both the Column 1 and Column 2 CPT codes to be paid when provided…
This article was originally published on May 20, 2019. Information has been updated as of June 3, 2019. Please read below for further details. Changes are coming to UnitedHealthcare and billing for outpatient therapy services. Failure to be aware of this change will cause your claims not to be paid beginning this summer. UHC has…
UnitedHealthcare (UHC) Community Plan will begin Site of Care Medical Necessity Reviews and are also revising their prior authorization requirements for occupational, physical and speech therapy services. Beginning with dates of service on and after
UnitedHealthcare has revised the following 2 Coverage Determination Guidelines with an effective date of February 1, 2019: Speech Language Pathology Services Habilitative Services and Outpatient Rehabilitation Services In addition, UnitedHealthcare updated their Cognitive Rehabilitation Medical Policy with an effective date of November 1, 2018. To access the guidelines and medical policies, log into your Gold…