As of March 1st, 2021, UnitedHealthcare has made several updates to their reimbursement policy for Advanced Practice Health Care Providers. The previous policy change was made on April 13th, 2020 when the word “Commercial” was added to the policy header.
Important Note: UnitedHealthcare reimbursement policies may use Current Procedural Terminology (CPT®), Centers for Medicare and Medicaid Services (CMS), or other coding guidelines. This specific policy applies to all health care services reported using the 1500 Health Insurance Claim Form (CMS-1500) and, when specified, those billed on UB04 forms.
This policy details the requirements for reporting the services of Advanced Practice Health Care Providers and other Nonphysician Providers, within a medical or other healthcare practice. An Advanced Practice Health Care Provider includes:
Policy Version Change
New Section Added:
Title and Section Verbiage Changes:
Section Verbiage Changes:
Questions and Answers Section:
History Section: Entries prior to 1/1/2019 archived
The complete policy and list of changes can be found here.
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