UnitedHealthcare Medicare Advantage to Reduce Payment When Services Provided by an Assistant

UnitedHealthcare (UHC) has announced they will reduce payment when services are provided in whole or in part by a physical therapist assistant or an occupational therapy assistant to UHC Medicare Advantage beneficiaries. In this article, I will answer the following questions:

1. When is the effective date of the payment reduction?
2. What is the payment reduction?
3. Will this payment reduction apply to outpatient therapy claims submitted on a 1500-claim form?
4. Does this policy apply to out-of-network (OON) providers?
5. Will this payment reduction apply to outpatient therapy claims submitted on a UB-04 claim form?
6. Does this policy apply to UnitedHealthcare Commercial plans?
7. Where can I access this information from UnitedHealthcare?

Let’s begin!

Question
When is the effective date of the payment reduction?

Answer

Question
What is the payment reduction?

Answer

Question
Will this payment reduction apply to outpatient therapy claims submitted on a 1500-claim form?

Answer

Question
Does this policy apply to out-of-network (OON) providers?

Answer

Question
Will this payment reduction apply to outpatient therapy claims submitted on a UB-04 claim form?

Answer

Question
Does this policy apply to UnitedHealthcare Commercial plans?

Answer

Question
Where can I access this information from UnitedHealthcare?

Answer

I hope you enjoyed this article. 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 Seminars & Consulting, Inc.

This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.