July 24, 2020 at 2:00 PM CT

COVID-19 Updates

With the 90-day continuance of the national public health emergency announced by the U.S. Department of Health and Human Services, UnitedHealthcare is extending our temporary COVID-19 measures. Visit our COVID-19 website for full details.  Please also refer to the Summary of COVID-19 Dates by Program and COVID-19 Testing and Treatment Billing Guide for coding and other billing guidance.

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COVID-19 Virtual Check-Ins

Last update: July 24, 2020, 2:25 p.m. CDT

Our Medicare Advantage and Individual and fully insured Group Market health plans currently 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 (Healthcare Common Procedure Coding System (HCPCS) code G2012) or captured video or image (HCPCS code G2010).

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 in- and out-of-network providers through the national public health emergency period for COVID-19 visits for new patients.

UnitedHealthcare will extend the expansion of telehealth access for in-network providers through Sept. 30, 2020, for non-COVID-19 visits. For out-of-network providers, the expansion of telehealth access will apply through July 24, 2020.

As of July 25, 2020, out-of-network virtual check-ins will only be covered according to the member’s benefit plan and UnitedHealthcare’s standard telehealth reimbursement policy.

UnitedHealthcare reimburses the following 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 Individual and Fully Insured Group Market Health Member Coverage and Cost Share section.

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.

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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.