COVID-19 Virtual Check-Ins

UnitedHealthcare reimburses the following Medicare-covered digital services for virtual check-ins: Services through several communication technology devices, such as telephone (HCPCS code G2012), captured video or image (HCPCS code G2010).

These virtual check-ins are for patients with a new or established relationship with a physician or certain practitioners, where the communication is not related to a medical visit within the previous seven days and does not lead to a medical visit within the next 24 hours (or soonest appointment available). The patient must verbally consent to receive virtual check-in services.

Details on member coverage and cost share can be found in the COVID-19 Telehealth Medicare Advantage Member Coverage and Cost Share section.

In accordance with state-specific regulations, our Medicaid plans will reimburse for “virtual check-in” patients to connect with their doctors remotely. These services are for new or established patients, not related to a medical visit within the previous seven days and not resulting in a medical visit within the next 24 hours (or soonest appointment available). These services can be billed when furnished through several communication technology modalities, such as telephone (HCPCS code G2012), captured video or image (HCPCS code G2010).

Medicaid state-specific requirements and time periods may vary. Medicaid state-specific rules supersede UnitedHealthcare extension guidelines and protocols as of June 18, 2020. If no state guidance was provided, the cost share waiver ended June 18, 2020 and UnitedHealthcare guidelines will apply. We will adjudicate benefits in accordance with the member’s health plan. For more details, please refer to your state-specific website.

Details on member coverage and cost share can be found in the COVID-19 Telehealth Medicaid Member Coverage and Cost Share section.

UnitedHealthcare will extend the expansion of telehealth access for certain in-network and out-of-network visits.

COVID-19 Visits

• For in-network providers, UnitedHealthcare will extend the expansion of telehealth access for COVID-19 testing and treatment through Dec. 31, 2020. From Jan. 1, 2021 and beyond, UnitedHealthcare will cover all in-network telehealth services as outlined in current CMS guidelines and additional codes as outlined in our Telehealth Reimbursement Policy.
• For out-of-network providers, UnitedHealthcare will extend the expansion of telehealth access for COVID-19 testing only through the end of the national public health emergency period on May 11, 2023.
• For out-of-network providers, UnitedHealthcare extended the expansion of telehealth access for COVID-19 treatment for new patients through Oct. 22, 2020. As of Oct. 23, 2020, out-of-network telehealth services are covered according to the member’s benefit plan and UnitedHealthcare’s standard telehealth reimbursement policy. 

Non-COVID-19 Visits

• For in-network providers, UnitedHealthcare will extend the expansion of telehealth access for new patients through Dec. 31, 2020. From Jan. 1, 2021, UnitedHealthcare will cover all in-network telehealth services as outlined in current CMS guidelines and additional codes as outlined in our Telehealth Reimbursement Policy.
• For out-of-network providers, the expansion of telehealth access ended July 24, 2020. As of July 25, 2020, out-of-network telehealth services are covered according to the member’s benefit plan and UnitedHealthcare’s standard telehealth reimbursement policy. 

Implementation of these temporary changes for self-funded customers may vary. Depending on a member’s health plan, providers may need to adjust their administrative processes and systems when collecting member cost share (copays, coinsurance and deductibles). To determine if a member has a self-funded plan, please call UnitedHealthcare Provider Services at 877-842-3210.

To help you understand how UnitedHealthcare is reimbursing telehealth services during the 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.

• UnitedHealthcare Telehealth Services: Care Provider Coding Guidance