Payment Policy Notifications
Review these payment policy updates to help code and submit your claims correctly.
Payment Policy Notification Updates
- New Emergency Department (ED) Professional Evaluation and Management (E/M) Coding Policy Will Be Effective October 1, 2020 - Date Posted 8.26.2019
- New Discarded Drugs and Biological Policy - UnitedHealthcare Community Plan of Tennessee - Date Posted 03.27.2019
- Revision to Readmission Policy for Facilities (Tennessee), Effective 02.01.2019 - Date Posted 01.22.2019
- Reprocessing Claims Affected by Our Multiple Procedure Reduction Reimbursement Policy (Tennessee) - Date Posted 01.16.2019
- Update to Non-Covered Codes and Covered Codes, Professional, Policy; codes S9083 & S9088 for Tennessee - Beginning April 1, 2019 - 12.17.2018
- Obstetrical Ultrasound Reimbursement Policy Update: Quantity Limitations, Effective Nov. 1, 2018 - 9.27.2018
- Update to the Emergency Department Facility Coding Policy – Beginning Nov. 1, 2018 - 9.27.2018
Review the following national payment policy updates to help code and submit your claims correctly
Current Payment Policy Notification Updates
- 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
Previous Payment Policy Notifications
- 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
- New Respiratory Viral Panel Testing - Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan of Wisconsin - Effective 11.01.2019
- New Respiratory Virus Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan of Tennessee - Date Posted 08.30.2019
- New Respiratory Virus Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan of Nebraska - Date Posted 08.30.2019
- New Respiratory Virus Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan MA and NC - Date Posted 08.30.2019
- New Respiratory Virus Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan AZ and TX - Date Posted 08.30.2019
- New Respiratory Virus Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan of FL, HI, MD, MI, OH, PA, and VA - Date Posted 08.01.2019
- New Respiratory Virus Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan of Missouri - Date Posted 07.31.2019
- New Respiratory Virus Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan of Rhode Island - Date Posted 07.31.2019
- New Respiratory Virus Panel Testing Professional and Facility Reimbursement Policy - UnitedHealthcare Community Plan of California - Date Posted 07.31.2019
- Readmission Review Frequently Asked Questions (Updated) - Dated Posted 06.26.2019
- Reimbursement Policy Updates for June 2019 - Date Posted 06.11.2019
- New York Payment Policy Change Notice ‒ CPT® codes 87631, 87632 and 87633 Discontinued for Reimbursement - Date Posted 05.07.2019
- New Emergency Room (ER) Services Reimbursement Policy for UnitedHealthcare Community Plan of Florida M*Plus Managed Medical Assistance (MMA) - Date Posted 03.25.2019
- We’re Reprocessing Claims Affected by Our Multiple Procedure Reduction Reimbursement Policy for UnitedHealthcare Community Plan of TX - Date Posted 2.15.2019
- Update to Observation Services Facility Policy –Starting March 1, 2019 (Nebraska, New York) - Date Posted 02.05.2019
- New Vitamin D Reimbursement Policy – Effective March 1, 2019 (New York only) - Date Posted 02.14.2019
- Claim Submission Tips to Help Meet CLIA Reimbursement Policy Claim Requirements - Date Posted 02.11.2019
- Reprocessing Claims Affected by Our Multiple Procedure Reduction Reimbursement Policy (Arizona, Louisiana, Mississippi, Nebraska, Texas Excluded) - Date Posted 01.16.2019
- Urgent Care Centers: Payment Policy Change for Codes S9083 and S9088 (Massachusetts only) - Effective April 1, 2019 - Date Posted 01.15.2019
- Update to Observation Services Facility Policy – Starting Feb. 1, 2019 (HI, KS, NJ) - Date Posted 01.15.2019
- New Cesarean Delivery Reimbursement Policy (New Jersey only) - Date Posted 01.02.2019
- Urgent Care Centers: Payment Policy Change for Codes S9083 and S9088 - Effective March 1, 2019 (Virginia only) - Date Posted 12.17.2018
- Readmissions Policy Frequently Asked Questions (Ohio, Virginia, Wisconsin only) - Date Posted 12.14.2018
- Update Obstetrical Ultrasound Reimbursement Policy effective January 1, 2019 (New Jersey only) - Date Posted 11.30.2018
- Update to the Emergency Department Facility Coding Policy – Effective January 1, 2019 (New Jersey only) - Date Posted 11.30.2018
- Update to the Emergency Department Facility Coding Policy – Effective January 1, 2019 (Maryland only) - Date Posted 11.30.2018
- Revision to Readmission Policy for Facilities - Effective March 1, 2019 (Wisconsin only) - Date Posted 11.30.2018
- Revision to Readmission Policy for Facilities - Effective March 1, 2019 (Virginia only) - Date Posted 11.30.2018
- Revision to Readmission Policy for Facilities - Effective February 1, 2019 (Ohio only) - Date Posted 11.21.2018
- November 2018 Reimbursement Policy Updates - Date Posted 10.29.2018
- Update to the Emergency Department Facility Coding Policy – Effective December 15, 2018 (Nebraska) - Date Posted 10.25.2018
- Obstetrical Ultrasound Reimbursement Policy Update: Quantity Limitations - Effective December 1, 2018 (Wisconsin only) - Date Posted 10.25.2018
- Obstetrical Ultrasound Reimbursement Policy Update: Quantity Limitations - Effective December 1, 2018 (Iowa only) - Date Posted 10.25.2018
- Obstetrical Ultrasound Reimbursement Policy Update: Quantity Limitations - Effective January 1, 2019 (Wisconsin only) - Date Posted 09.27.2018
- Obstetrical Ultrasound Reimbursement Policy Update: Quantity Limitations - Effective November 15, 2018 (Nebraska only) - Date Posted 09.27.2018
- New Cesarean Delivery Reimbursement Policy - Effective November 1, 2018 (Ohio only) - Date Posted 09.26.2018
- New Cesarean Delivery Reimbursement Policy - Effective November 1, 2018 (Pennsylvania only) - Date Posted 09.26.2018
- New Cesarean Delivery Reimbursement Policy - Effective November 15, 2018 (Nebraska only) - Date Posted 09.26.2018