UHC Community Plan Medicaid Covered and Non-Covered CPT Codes
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
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To access the policy for providers who submit claims on a UB-04 claim form, click
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When it says Ohio and PA are not administered by this policy, it means it does not apply to those states?
As in, UHC Community Plan Medicaid is not accepted in those states for facility billing on UB04s? So, if a pt admitted to one of our facilities with that insurance, we would know that therapy is not covered in OH or PA for those patients? I just want to make sure I understand. Thank you
Yes to your first question.
Hey Rick,
Any changes for Louisiana?
I was unable to see any of the attachments or any codes listed for any states.
That is a UHC issue and you would need to contact UHC.