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UnitedHealthcare (UHC) Announces Telehealth Coverage

COVID-19

UnitedHealthcare (UHC) Announces Telehealth Coverage

UnitedHealthcare will reimburse physical, occupational and speech therapy telehealth services provided by qualified health care professionals when rendered using interactive audio/video technology. State laws and regulations apply. Benefits will be processed in accordance with the member’s plan. For out-of-network providers, please contact UHC to confirm if the member's plan benefits allow telehealth services.

UnitedHealthcare’s expansion of telehealth services to include outpatient physical, occupational and speech therapy services was due to expire on June 18, 2020. Due to the continued COVID-19 Public Health Emergency, UnitedHealth (UHC) will now cover outpatient physical, occupational and speech therapy delivered via telehealth until September 30, 2020 for their Medicare Advantage plans and until July 24, 2020 for Individual and fully insured Group Market health plans.

UHC will continue to waive cost-sharing for Medicare Advantage members for in-network telehealth services for PT/OT/ST services from March 31, 2020 until Sept. 30, 2020.

For Individual and Fully Insured Group Market Health Plans, UHC will do the following regarding cost-sharing:

  • For COVID-19-related visits, cost sharing will be waived for in-network telehealth services for PT/OT/ST services from March 31, 2020 through July 24, 2020, with opt-in available for self-funded employers.
  • For non-COVID-19 visits, cost sharing will be waived for in-network telehealth services for PT/OT/ST services from March 31, 2020 through June 18, 2020, with opt-in available for self-funded employers.

For telehealth services, UHC will only provide payment for the following CPT codes:

  • 97161 PT evaluation low complexity
  • 97162 PT evaluation moderate complexity
  • 97163 PT evaluation high complexity
  • 97164 PT re-evaluation
  • 97110 Therapeutic exercise
  • 97112 Neuromuscular re-education
  • 97116 Gait training
  • 97530 Therapeutic activities
  • 97535 Self-care/home management training

UnitedHealthcare will reimburse eligible codes when submitted with a place of service code 02 and modifier 95. Click here for more information.