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.

Skip left navigation

COVID-19 Prior Authorization and Ongoing Patient Care Updates

Last update: June 2, 2020, 2:45 p.m. CDT

UnitedHealthcare is working to help people access health care to the fullest extent possible as we come together to address the national public health emergency. We’re adopting measures that will reduce administrative burden for physicians and facilities and help members more easily access the care they need under their benefit plan.

NEW – Waiving Cost Share for Medicare Advantage Members for Both Primary and Specialty Care Office Visits

UnitedHealthcare is waiving cost share (copays, coinsurance and deductibles) for UnitedHealthcare Medicare Advantage plan members for all office-based professional services performed by both primary care physicians and specialists. UnitedHealthcare will reimburse the full cost share the health care professional would have received from the member. This applies for dates of service starting May 11, 2020 until at least Sept. 30, 2020. Waiving cost share for primary care and specialty care, along with our telehealth cost share waiver, can make it easier for members to get the care they need, however they choose to access it.

Eligible Services

The waiving of cost share for Medicare Advantage members applies to professional services performed by both primary care physicians as well as specialists, no matter the diagnosis or reason for the visit. It applies to the following categories:

  • Primary care physician office visits
  • Specialist physician office visits
  • Physician assistant or nurse practitioner office visits
  • Chiropractic and acupuncture services (Medicare-covered)
  • Eye exams, hearing exams and podiatry visits (Medicare-covered or additional covered benefits)
  • Physical therapy, occupational therapy and speech therapy in an office or outpatient setting
  • Cardiac and pulmonary rehabilitation services in an office or outpatient hospital setting
  • Outpatient mental health and substance abuse visits in an office or outpatient setting
  • Opioid treatment services in an office, outpatient hospital or opioid treatment center setting

However, member cost share is not waived in any place of service for:

  • Inpatient services, outpatient surgery and observation
  • All skilled nursing services
  • All home health services
  • Lab and diagnostic tests (radiological and non-radiological)
  • Part B drugs, including chemotherapy and radiation therapy
  • Part D drugs
  • Durable medical equipment/prosthetics/supplies
  • Renal dialysis

Cost share is waived for covered services from a network provider or covered out-of-network services.

Eligible Members

The waiving of cost share applies to all UnitedHealthcare Medicare Advantage members, including Group and all Special Needs Plan (SNP) members.

As needed, we’re also adjusting programs and services to protect members and help limit the spread of the COVID-19 virus in communities. We may also temporarily suspend or relax additional policies as needed in regions where inpatient capacity is most compromised and at risk.

Systems are being updated to reflect these changes. Please check back often for the latest information.


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. 

Submit Feedback

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.