UnitedHealthcare Delays Changes in Consultation Code Policy

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  • December 28, 2017
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UnitedHealthcare Delays Changes in Consultation Code Policy

In August 2017, UnitedHealthcare (UHC) indicated they would no longer reimburse inpatient and outpatient consultation codes, as of Oct. 1, 2017. When the implementation date came, UHC indicated they would delay the consultation services revision until 2018:

We previously announced that certain revisions to the Consultation Services Reimbursement Policy would become effective for UnitedHealthcare Commercial members on Oct. 1, 2017. In an effort to give care providers more time to adjust to potential changes in their submission of procedure codes for consultation services, UnitedHealthcare will be delaying implementation of the revisions to the Reimbursement Policy for services reported with consultation codes 99241-99245 and 99251-99255.

UHC did not rescind its decision; they only delayed implementation to pursue “data analysis and trending,” further. Check with your carriers for their latest policies when billing consultation services.
Resource: RAC Monitor, “Breaking: UnitedHealthcare Appears to Delay Eliminating Consultation Codes”

Michelle Dick
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Michelle A. Dick, BS, is a freelance content specialist, providing writing, editorial expertise, and graphic imagery to clients. Prior to becoming a free agent, she was an executive editor for AAPC, editor-in-chief at Eli Research, and editor at Element K Journals. After earning a Bachelor of Science from the State University of New York at Buffalo State, Dick entered the publishing industry as a graphic artist, ad coordinator, and web designer for White Directory Publishers, Inc.

No Responses to “UnitedHealthcare Delays Changes in Consultation Code Policy”

  1. Dawn Nunning says:

    It is my understanding from the above that the Medicare and Medicare Advantage members plans will not be in this reconsideration to pay for the Consult codes you have listed above, correct??