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Alert: Changes Coming to UnitedHealthcare’s Consultation Services Policy – Some Codes Will No Longer Be Reimbursed
Posted on: 4/18/2019

ISMS was instrumental in getting this change postponed by more than a year. 

UnitedHealthcare (UHC) is revising its Consultation Services Policy and will no longer reimburse CPT® codes 99241 through 99255. According to UHC, this change aligns with reimbursement policies from the Centers for Medicare and Medicaid Services (CMS). In 2010, CMS established policy to no longer reimburse codes for consultation services. 

The effective dates for the UHC change fall into two categories:

      
  • Effective June 1, 2019, UnitedHealthcare will no longer reimburse CPT® codes 99241-99255 when billed by any health care professional or medical practice with a participation agreement that includes contract rates determined in 2010 or later.

  • Effective Oct. 1, 2019, UnitedHealthcare will no longer reimburse CPT® codes 99241-99255 when billed by any health care professional or medical practice.

If you are billing electronically, UHC is providing notice on its remittances.

For more details, access UHC’s April Bulletin; scroll down to Page 24.

Questions? Contact our advocacy team by calling 800-782-4767 ext. 1470, or by sending an email.



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