On January 1, 2021, outpatient physical, occupational and speech therapy services provided via telehealth for UnitedHealthcare (UHC) commercial plans will be changing and there will be a difference in telehealth coverage between providers who submit claims on a 1500-claim form and providers who submit claims on a UB-04 claim form.
Question
What is changing on January 1, 2021 for UHC Commercial plans?
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Question
What place of service (POS) code is to be used on the claim form for an outpatient therapy visit conducted via telehealth?
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What is changing on January 1, 2021 for UHC Medicare Advantage plans?
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Mr. Gawenda has presented nationally since 2004 and currently presents approximately 100 dates per year around the United States.
“To access the UHC Telehealth/Telemedicine Policy, Professional, click HERE” ……..this option keeps failing and states “failed load of PDF”
That is a UHC issue and hopefully they will fix that soon.
COVID-19 Physical Health, Occupational and Speech Therapy
Last update: December 30, 2020, 12:45 a.m. CST
UnitedHealthcare will reimburse physical, occupational and speech therapy (PT/OT/ST) telehealth services provided by qualified health care professionals when rendered using interactive audio-video technology.
Reimbursable codes are limited to the specific set of physical, occupational and speech therapy codes listed here.Opens in a new window UnitedHealthcare will reimburse eligible codes using the place of service that would have been reported had the services been furnished in person on a CMS 1500 with 95 modifier or a UB04 form with applicable revenue codes.
I read this to indicate that facilities billing using a UB04 will be reimbursed after 1/1/2021. Am I reading this incorrectly?
Go back to that same website and click on “Individual and Fully Insured Group Market Health Plans” Under Non-COVID 19 Visits, notice the expiration date of telehealth.
Now that PT providers are to report POS 02 – is a modifier still required? Previously, we were billing POS 11 with Modifier 95. Can you confirm? I do not see detail on modifier requirements for 1500 forms in the UHC Telehealth Policies. Thank you.
Please read the UHC telehealth policy on the top of page 2 for your answer.