May 29, 2020

COVID-19 End Date and Billing Guidance

Keep track of which temporary measures are expiring and which are being extended with our Summary of COVID-19 Dates by Program guide. When it’s time to submit a claim, check our COVID-19 Provider Billing Guidance reference guide.

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COVID-19 Telehealth Services

Last update: May 31, 2020, 12:00 p.m. CDT

NEW! Date Expansion and Cost Share Updates for Telehealth Services

UnitedHealthcare is expanding the dates through which we are waiving the Centers for Medicare & Medicaid Services (CMS) originating site restriction for Medicare Advantage, Medicaid and Individual and fully insured Group Market health plan members. We are also updating the cost share waiver period for in-network telehealth services. The date changes vary by health plan, so please review each section for details.

 

NEW! Audio-Only Telehealth Requirements for Medicare Advantage

Consistent with CMS requirements, effective immediately for all Medicare Advantage plans, including DSNP plans, we require care providers to bill audio-only telehealth visits using audio-only codes. For Medicaid and Individual and fully insured Group Market health plan members, eligible care providers can bill for telehealth services performed using either interactive audio-video or audio only, except in cases where we have explicitly denoted the need for interactive audio-video, such as with PT/OT/ST, while a patient is at home. 

Telehealth

A visit with the provider who uses an audio-video or audio-only telecommunications system.

Virtual Check-Ins

A brief check-in with the provider using a recorded video and/or images submitted by the patient.

Electronic Visits

Communication between a patient and his/her provider through an online patient portal.

PT, OT and ST Telehealth

Specific CPT® codes are eligible for reimbusement.

Chiropractic Therapy

Specific CPT® codes are eligible for reimbursement.

Home Health and Hospice

Details on eligible services and reimbursement.

Remote Patient Monitoring

Details on eligible services and reimbursement.

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We’re listening.

We’re committed to keeping you up to date on COVID-19 – we’re monitoring your inquiries and working hard to answer your questions. Let us know how we’re doing.

We’ll be making daily updates to this site. Be sure to check back often for the latest information. 

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Disclaimer:

The benefits and processes described on this website apply pursuant to federal requirements and UnitedHealthcare national policy during the national emergency.  Additional benefits or limitations may apply in some states and under some plans during this time.

We will adjudicate benefits in accordance with the member’s health plan.

Medicaid Providers: UnitedHealthcare will reimburse out-of-network providers for COVID-19 testing-related visits and COVID-19 related treatment or services according to the rates outlined in the Medicaid Fee Schedule.