Telehealth services protocol - Chapter 8, 2021 UnitedHealthcare Administrative Guide

For the year 2021, UnitedHealthcare will consider reimbursement for telehealth services performed while the member was at home or another originating site under certain commercial and MA benefit plans.

To be eligible for payment, you must meet the following telehealth service requirements.

  • Comply with the American Medical Association (AMA) and Federation of State Medical Board guidelines, which require all telemedicine visits use live interactive audio and video and visual transmission of a physician-patient encounter. For UnitedHealthcare individual and fully-insured group market plans, some state-specific variations may apply.
  • Use a secure technology platform that meets federal and state requirements for security and confidentiality of electronic member information.
  • Comply with all applicable federal and state laws concerning the security and confidentiality of member information, including HIPAA and its governing regulations.
  • Maintain member records related to telehealth services in a secure medium that meets federal and state requirements for encryption and security of electronic member information.
  • Offer telehealth services in a clean, private space and not in vehicles or public spaces.
  • Code the telehealth services in accordance with applicable reimbursement policies.