UHC Community Plan Reimbursement Policy Updates

May 10, 2021
Rick Gawenda

UnitedHealthcare Community Plan has published a new reimbursement policy regarding ICD-10 diagnosis coding on a UB-04 claim form. The states that are impacted by this new policy include the following:

  • Arizona
  • California
  • Florida
  • Hawaii
  • Maryland
  • Michigan
  • Mississippi
  • Missouri
  • Nebraska
  • New Jersey
  • New York
  • Ohio
  • Pennsylvania
  • Texas
  • Virginia
  • Washington
  • Wisconsin

The effective date is June 1, 2021 for all of the above states except for New York and Texas. The effective date for New York and Texas is July 1, 2021.

This new policy will deny claims where an inappropriate diagnosis is in Box 67 on a UB-04 claim form or its electronic equivalent. To access this new policy, click

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