Multiple Therapy Procedure Reduction policy change

Last modified: March 1, 2021

Nebraska: UnitedHealthcare Community Plan policy change

Physical medicine & rehabilitation: Multiple therapy procedure reduction
UnitedHealthcare Community Plan of Nebraska has updated our policy to exempt Nebraska Community Plan health care professionals from the Physical Medicine & Rehabilitation: Multiple Therapy Procedure Reduction Policy, Professional (Policy Number 2021R0121C), as of Jan. 1, 2021.  

How this affects you
Starting Jan. 1, 2021, providers who participate in UnitedHealthcare Community Plan of Nebraska and bill with the 1500 health insurance claim form will no longer have claims reduced for the PE portions of all secondary and subsequent procedures from the Multiple Therapy Reducible Codes list. This includes procedures with indicator 5 in the Multiple Procedure Payment Reduction (MPPR) field on the CMS National Physician Fee Schedule  performed by the same group physician and/or other health care professional to the same patient on the same day.

All claims that have processed and applied the multiple therapy procedure reduction will be reprocessed back to Jan. 1, 2021.

Questions?
Please call 866-331-2243.