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Payment Policy Notifications

Review these payment policy updates to help code and submit your claims correctly

Current Payment Policy Notification Updates

2021 Payment Policy Notifications are now located within the Network Bulletin

Previous Payment Policy Notifications

OPS MMA-LTC 006 Claim Payment for Florida
Treatment In Place - Billing Guidelines for Louisiana
New Emergency Department (ED) Professional Evaluation and Management (E/M) Coding Policy – implementation delay for FL, CA, HI, RI, TX, OH, AZ, MO, MD
Sexually Transmitted Infection Testing Policy for UnitedHealthcare Community Plan of Mississippi, Professional and Facility Effective January 1, 2021
New Vitamin D Reimbursement Policy for UnitedHealthcare Community Plan of Louisiana - Effective Dec. 1, 2020
New Inappropriate Primary Diagnosis Facility Policy for UnitedHealthcare Community Plan of AZ, FL, MD, MI, MS. OH, PA, VA, WI - Effective Nov. 1, 2020
New Inappropriate Primary Diagnosis Facility Policy for UnitedHealthcare Community Plan of Texas and New York - Effective Jan. 1, 2021
New Inappropriate Primary Diagnosis Facility Policy for UnitedHealthcare Community Plan of California - Effective Nov. 15, 2020
New Inappropriate Primary Diagnosis Facility Policy for UnitedHealthcare Community Plan of Missouri - Effective Dec. 1, 2020
Sexually Transmitted Infection Testing Policy, Professional and Facility - UnitedHealthcare Community Plan of Tennessee - Effective 10/1/2020
Outpatient Physical & Occupational Services Covered & Non-Covered CPT Codes - Network Bulletin Appendix - UnitedHealthcare Community Plan of NY - Effective Sept. 1, 2020
Updated: Ambulance Policy Professional - UnitedHealthcare Community Plan of Texas - Effective Nov. 1, 2020
Updated: Ambulance Policy Professional - UnitedHealthcare Community Plan of Virginia - Effective Sept. 1, 2020
Updated: Ambulance Policy Professional - UnitedHealthcare Community Plan of California - Effective Oct. 1, 2020
New Sexually Transmitted Infection Policy, Professional and Facility - Effective Sept. 15, 2020
Sexually Transmitted Infection Testing Policy for FL, MD, PA, VA, WI - Effective Aug. 1, 2020
Sexually Transmitted Infection Testing Policy for MI, VA - Effective Sept. 1, 2020
Sexually Transmitted Infection Testing Policy for FL, MD, PA, VA, WI - Effective Oct. 1, 2020
New Emergency Department (ED) Evaluation and Management (E/M) Coding Policy for FL, TX, OH, AZ, MO - Effective October 1, 2020
Updated Respiratory Viral Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan of TN - Effective June 25, 2022
Updated Respiratory Viral Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan of CA, FL, HI, MD, MA, MI, MO, NE, NJ, OH, PA, RI, TX, VA, WA, WI - Effective June 22, 2022
Delay: Procedure to Modifier Policy, Professional – UnitedHealthcare Community Plan of CA, DE, FL, HI, MD, MI, MS, NE, NJ, NY, OH, PA, RI, WI - Effective July 1, 2020
Update: Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy, Professional - UnitedHealthcare Community Plan of FL, HI, MD, MI, OH, PA, VA - Effective March 31, 2020
Update: Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy, Professional - UnitedHealthcare Community Plan of CA - Effective April 16, 2020
Update: Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy, Professional - UnitedHealthcare Community Plan of MA, MO - Effective May 1, 2020
Update: Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy, Professional - UnitedHealthcare Community Plan of NY, RI - Effective May 31, 2020
Update: Laboratory Services Policy, Professional - UnitedHealthcare Community Plan of AZ, CA, FL, HI, KS, MD, MA, MS, MO, NE, NJ, NY, PA, RI, TN, TX, VA, WA, WI - Effective May 18, 2020
Update: the Physical Medicine and Rehabilitation Multiple Therapy Reduction Policy, Professional will be processing by date of service for CA, FL, HI, MD, MA, MI, MO,NY,OH,PA,VA, WA, WI - Effective 06.01.2020
Updated: Obstetrical Ultrasound Reimbursement Policy Update: Quantity Limitations - Effective April 1, 2020 (Mississippi only)
Updated Procedure to Modifier Policy, Professional – Always Therapy: GN, GO, and GP modifiers Required - Effective April 1, 2020 - UnitedHealthcare Community Plans of CA, FL, HI, MD, MA, MI, MO, NE, NY, OH, PA, RI, VA, WA, and WI
Update: Intraoperative Neuromonitoring Policy, Professional and Facility - Effective May 01, 2020 - UnitedHealthcare Community Plans of CA, FL, HI, MD, MA, MI, MO, NE, NY, OH, PA, RI, VA, WA, and WI
New York Payment Policy Change Notice - Discontinuation of Reimbursement for Hyaluronic Acid for Treatment of Osteoarthritis of the Knee - Effective Jan 1, 2017 - Date Posted 01.22.2019
New Policy: Advanced Practice Health Care Provider Policy: New Jersey, Professional - Effective January 15, 2020
National Drug Code (NDC) Requirement Policy, Professional and Facility - UnitedHealthcare Community Plans of AZ, DE, FL, HI, IA, MA, MD, MI, MO MS, NE, NJ, NM, NY, OH, PA, RI, TX, VA, WA, and WI - Effective March 1, 2020
Updated Professional Technical Component Policy, Professional - UnitedHealthcare Community Plans of DE, FL, HI, MA, MD, MI, MO, NY, OH, PA, RI, VA, WA, and WI - Effective Feb. 1, 2020
New Policy: Advanced Practice Health Care Provider Policy, Professional - UnitedHealthcare Community Plan of New Jersey - Effective January 15, 2020
Electronic Visit Verification Requirement FAQ - UnitedHealthcare Community Plan of Florida - Effective 12.01.2019
New Respiratory Virus Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan of New Jersey - Effective 11.15.2019
Reimbursement Notice for Evaluation and Management Services Performed During Global Obstetrical Care - UnitedHealthcare Community Plan of Tennessee
Emergency Department Coding Policy Update - UnitedHealthcare Community Plan of Rhode Island - Effective 11.01.2019