Medical Practices Consulting / UnitedHealthcare Telehealth and Telemedicine Policy Modifications Effective 1/1/2021

UnitedHealthcare Telehealth and Telemedicine Policy Modifications Effective 1/1/2021

In the latest Provider Newsletter, UnitedHealthcare (UHC) revealed their revised telehealth reimbursement policies for 2021.

Among the revisions, UHC is changing the Place of Service (POS) for telehealth services. During the COVID-19 PHE, UHC requested that POS for telehealth services be submitted as POS 11 (as if the service was performed in the office), along with modifiers 95, GT, GQ or G0 (whichever one is appropriate.)

Effective January 1, 2021, UHC will only consider telehealth services for reimbursement under this new policy when reported with POS 02. Modifiers 95, GT, GQ or G0 may be appended to telehealth claims reported with POS 02, but the modifiers will be considered informational and not necessary to identify telehealth services.

Various CPT codes will be eligible for consideration under the new policy including CPT codes listed in the current policy, as well as similar types of services rendered using interactive audio and video technology. Currently, UHC allows for audio/visual and audio only services. It is unclear whether the audio only services will be allowed under the revised policy.

Additionally, UHC telehealth services must be rendered using only live, interactive audio, and video platforms recognized by CMS and the AMA.Educate your practice on the revised policies and make sure you stay informed and up to date. Sign up for the UHC email communications.

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