Virtual Care - Chapter 4, 2022 UnitedHealthcare Administrative Guide

Individual Exchange plans include access to virtual care. Members can use virtual visits for urgent or primary care services. The virtual visit benefit has a separate defined copayment. Members may access virtual visits from their online account at myuhc. com/exchange or by connecting with local in-network health care providers who offer virtual care.

Individual Exchange members may also use virtual visits to access behavioral health services. With this benefit, members can talk to an Optum participating licensed therapist or psychiatrist for the evaluation and treatment of behavioral health conditions such as depression and anxiety. Members can schedule their appointment online with some providers or call the health care provider directly to schedule.

Billing for virtual care services

UnitedHealthcare will consider reimbursement for eligible virtual care services when they are given by audio and video with a place of service POS 02. The Distant Site is where the rendering health care provider is housed during a virtual care encounter and is reported on the claim with POS 02 in Box 24B on the 1500 claim form.

We do not require you to report one of the virtual care-associated modifiers (GT, GQ, G0 or 95) when performing a service, but modifiers are accepted as informational if reported on a claim with eligible virtual services. For additional coding guidelines, refer to UnitedHealthcare Telehealth and Telemedicine Policy, Professional on