Last update: May 21, 2020, 3:50 p.m. CDT
For Medicare Advantage, Individual and Group Market health plan and Medicaid members, UnitedHealthcare will reimburse for patients to communicate with their doctors using online patient portals, using CPT codes 99421-99423 and HCPCS codes G2061-G2063, as applicable.
Our Medicare Advantage, Medicaid, and Individual and Group Market health plans currently reimburse for “e-visits” for patients to connect with their doctors remotely. These services are for established patients, not related to a medical visit within the previous 7 days and not resulting in a medical visit within the next 24 hours (or soonest appointment available).
UnitedHealthcare Individual and Group Market health plans, Medicare Advantage and some Medicaid plans pay for e-visits in all types of locations, including the patient’s home, and in all areas (not just rural). Established patients may have non-face-to-face, patient-initiated communications with their doctors, without going to the doctor’s office, by using online patient portals.
These services can only be reported when the billing practice has an established relationship with the patient. For these e-visits, the patient must generate the initial inquiry, and communications can occur over a 7-day period. For these services, UnitedHealthcare reimburses CPT codes 99421-99423 and HCPCS codes G2061-G2063, as applicable. The patient must verbally consent to receive virtual check-in services.
Until June 18, 2020, UnitedHealthcare will extend this reimbursement to all Medicaid plans.
To help you understand how UnitedHealthcare will reimburse telehealth services during the COVID-19 national public health emergency period, we created a telehealth coding guide that includes scenarios to show some examples of how services might be reimbursed. UnitedHealthcare’s temporary changes to its reimbursement policies do not alter state and federal laws applicable to your practice. This document applies to dates of service from March 18, 2020 through June 18, 2020, unless UnitedHealthcare extends the end date.
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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.