Care Plan Oversight Policy - Reimbursement Policy - UnitedHealthcare Commercial Plans
Care Plan Oversight (CPO) Services refer to physician and other qualified health care professional supervision of patients under the care of home health agencies, hospice, or nursing facilities. Care Plan Oversight services are reported separately from codes for office/outpatient, hospital, home, nursing facility, or domiciliary services. Code selection for Care Plan Oversight Services is determined by the complexity and approximate time spent by the physician or other qualified health care professional within a 30-day period.
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Click to Download: Care Plan Oversight Policy - Reimbursement Policy - UnitedHealthcare Commercial Plans
Questions and Answers
Q: Does UnitedHealthcare reimburse Care Plan Oversight Services codes for less than 30 minutes?
A: UnitedHealthcare follows CMS payment methodology for reimbursement of Care Plan Oversight Services. According to the CMS Medicare Benefit Policy Manual, Covered Medical and Other Health Services, Chapter 15, Section 30, these services are covered only if the physician furnished at least 30 minutes of Care Plan Oversight within the calendar month for which payment is claimed.