Payment Policy Notifications

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
• 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