UnitedHealthcare is launching new benefit designs for outpatient diagnostic lab and imaging services to help drive patient transparency and manage the cost of healthcare. Outpatient diagnostic lab services and imaging will be covered at the highest tier for fully insured commercial members.
Beginning July 1, 2021, outpatient lab services will be paid at the highest tier for members when delivered by a Designated Diagnostic Provider. If a member has this benefit and receives services from a provider that is not a Designated Diagnostic Provider, services will be paid at the lowest tier available.
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Designated Diagnostic Providers are designed to support our members in choosing cost-effective and high-value care providers. Effective July 1, 2021, in select state markets and subject to state regulatory approval, outpatient diagnostic lab services will be covered at the highest tier for members choosing care providers delivered by Designated Diagnostic Providers.
The Designated Diagnostic Provider will expand to major imaging services (computed tomography [CT], magnetic resonance imaging [MRI], magnetic resonance angiogram [MRA], positron emission tomography [PET], nuclear medicine) for fully insured commercial and Oxford members. This change will begin Jan. 1, 2022, subject to state regulatory approval.