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November 01, 2022

The return to normal — focus on annual visits

It’s good news that, as the COVID-19 public health emergency eases, people can return to more familiar routines, including getting their annual wellness check-ups. 

Between now and the end of the year, we will increase the reimbursement you receive on completed annual wellness visits for UnitedHealthcare Community Plan (Medicaid) patients.

Important things you need to know

  • Between now and Dec. 31, 2022, we are increasing reimbursement for completed annual wellness visits for UnitedHealthcare Community Plan (Medicaid) members, excluding Dual Eligible Special Needs Plans (D-SNP) members, by 50% of the allowed amount on your claim. Some exclusions apply.*
  • The increase applies to claims with dates of service Oct. 1, 2022–Dec. 31. 2022, with a claim receipt date no later than March 31, 2023.  Claims must be billed with the appropriate CPT®/DX code. 
  • Appropriate CPT/DX codes are 99381-99387 and 99391-99397 and the appropriate Healthcare Effectiveness Data and Information Set (HEDIS®) measure Adult Access to Preventative Ambulatory Health Services (AAP), Well Child Visit (WCV) and Well Child Visit within first 30 months of life (WV30) DX codes.

Questions?

For more details, you can check our Frequently Asked Questions.

*Exclusions include providers paid via capitation, providers participating in our Nevada and Colorado health plans and certain provider-type exclusions within Louisiana including Federally Qualified Health Centers (FQHC), Rural Health Centers (RHC) and Indian Health Centers (IHC).
CPT is a registered trademark of the American Medical Association.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)
PCA-1-22-03396-C&S-NEWS_10122022
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