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Wiki Wellness exams

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lwilkes

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Lyons, CO
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I need information on the United Healthcare Medicare exams. I was told and so was a patient, that UHC allows 2 exams per year that are free to the patient. One is the wellness exam billed with the appropriate G code, and one is a comphrensive physical. How do you bill the comprehensive physical? All UHC will say is that they follow Medicare guidelines. If you bill with standard E&M codes they will have a copay, and Medicare doesn't recognize the 99397 code. Any ideas or experience with this situation?
 
We bill the appropriate code usually a 99214 or 99215 with a 25 modifier then the G0439 Subsequent physical code for Medicare and have been getting paid.
 
I have billed UHC Medicare with 99397 and they have paid. I do not know about the two physicals a year, that is the first I've heard of that.
 
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