• Major insurer extends COVID-related telehealth expansion through September

    UnitedHealthcare (UHC) announced last week it is extending through Sept. 30, 2020, its temporary telehealth expansion spurred by the COVID-19 pandemic. The extension applies to UHC’s plans in Medicare Advantage, as well as in the individual and fully insured group markets. UHC will continue to waive the Centers for Medicare & Medicaid Services (CMS) originating site requirement, and will continue to pay physicians and other qualified health providers for telehealth visits at parity with the rate they would receive for an in-person visit. More details are available on UHC’s COVID-19 website.

    Like Medicare, many private payers have expanded their telehealth policies during the pandemic — which has been declared a national health emergency — by waiving restrictions and out-of-pocket costs and allowing physicians to bill and be paid for telephone-only services/codes.  

    UHC, the nation's largest private health insurer, also announced last week it’s continuing its temporary waiver of member cost sharing for telehealth visits for medical, outpatient behavioral, physical, occupational and speech therapy, chiropractic therapy, home health, hospice and remote patient monitoring services, with opt-in available for self-funded employers.

    • For out-of-network telehealth services related to COVID-19, UHC is waiving cost sharing for the duration of the national public health emergency, which is currently set to expire July 25.
    • For in-network telehealth services, whether related to COVID-19 or not, UHC will extend the cost share waiver through Sep. 30, 2020.*

    *Per UHC, this date is subject to change based on direction from CMS.

    In conjunction with the announcement, UHC updated its Summary of COVID-19 Dates by Program and COVID-19 Testing Guidance.

    Telehealth billing and coding guidance for the largest national payers is available here. This guidance is ever evolving, so stay tuned for future announcements and developments.

    — Kent Moore, Senior Strategist for Physician Payment at the American Academy of Family Physicians

    Posted on Jun 29, 2020 by Kent Moore

    Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.