UnitedHealthcare Delays Changes in Consultation Code Policy

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 Dick

Executive Editor at AAPC
Michelle A. Dick has been executive editor for AAPC for over 10 years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. She has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.
Michelle Dick
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About Has 202 Posts

Michelle A. Dick has been executive editor for AAPC for over 10 years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. She has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.

One Response 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??

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