Wiki United Healthcare Audio only

Create Wiki
J

JesseL

Expert
Messages
404
Location
Bronx, NY
Best answers
0
Is anyone else confused that United Healthcare is saying to bill E&M codes for audio only visits? They say they're not covering for 99441-99443 because Medicare doesn't cover them (even though Medicare does now as of the beginning of this month) but they wan't us to bill those with regular office visit codes? By time??

"Audio-only Services Billed with E/M Codes
For Individual and Group Market health plans, Medicaid and Medicare Advantage members, UnitedHealthcare has waived audio-video requirements and will reimburse telehealth services provided through live, interactive audio-visual or audio-only transmission to new or existing patients whose medical benefit plans cover telehealth services, unless otherwise permitted by state law. "

 
Private carriers are MOSTLY following CMS guidelines, but some (as your example above) are creating their own policies and guidelines. Also, some carriers came up with policies, and then CMS expanded telehealth further 03/30/20, but the private carrier did not want to revise their policy. Some just came up with a simple "we'll do whatever CMS is doing" policy.
If you have it from the carrier clearly stating audio only should be billed 99201-99215, then you obviously may follow that policy for that specific carrier.
Most of the telehealth will be based on time (even video evaluations) since exam is at best problem focused. Especially since almost all of the time is spent counseling/coordination of care. Just make sure the time gets properly documented.
 
I'm even more confused now because they're now saying they're covering 99441-99443 under their virtual check-in section.

BUT, their guide still suggests to bill E&M for audio only visits. https://www.uhcprovider.com/content...enarios.pdf?cid=em-other-covid-19email4-apr20.

Is anyone else confused with how to bill UHC for these audio only visits?🤷‍♂️
 
Any carrier that I have in writing from them to bill E/M for audio only, I am taking advantage of.
Why get paid $30 for 15 minutes when you can get paid $60 for 15 minutes following their own policy? 🤑
 
We are billing all the audio-only visits for commercial and government insurances as 99441-99443.
 
I'm not up to date on all the United Healthcare nuances, but my understanding is that they now have different rules for different states. Some states are still in a declared public health emergency and others are not. For Medicare members, they are following CMS guidance. For commercial members, some states are covered and some are not.
 
You must log in or register to reply here.
Top