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  • UnitedHealthcare Allows Telehealth for Physical Therapy

    The major change, effective until June 18, permits PTs to be reimbursed for telehealth services using the company's typical billing codes but is subject to state laws and regulations.

    UnitedHealthcare, the country's largest commercial health insurer, announced a major shift in its coverage policies during the COVID-19 pandemic: Beginning immediately, the payer will reimburse physical therapy delivered via telehealth services. The change is the most wide-ranging payer acknowledgement of PTs as qualified telehealth providers to date, and it moves UHC well past CMS' and a few other payers’ current waivers allowing for limited "e-visit" digital communications between PTs and patients.

    The new benefits are set to end on June 18 and are subject to state laws and regulations around telehealth, but, if permissible, they enable PTs, occupational therapists, and speech therapists to provide true telehealth services and use their typical billing codes. Eligible codes will be reimbursed by UHC with a place-of-service code 02 and the 95 modifier.

    The UHC change is a significant improvement for PTs. Until now, national private insurers including UHC and Aetna, have been following CMS' lead and allowing only e-visits, a limited form of digital communication restricted to only a portion of codes, and not truly considered telehealth.

    While the COVID stimulus package on the horizon allows the U.S. Department of Health and Human Services to apply a waiver permitting PTs to engage in telehealth for Medicare beneficiaries, those waivers are unlikely to happen without a strong advocacy effort from the physical therapy profession — an effort that APTA is facilitating through a template letter to send to CMS that makes the case for the change.

    Carmen Elliott, MS, APTA's vice president of payment and practice management, said that the UHC change is big news.

    "The fact that the largest insurer in the country has temporarily shifted its reimbursement policies around telehealth is important in terms of patient and provider care and safety during this pandemic," Elliott said. "But it's also a tremendous opportunity for the physical therapy profession to demonstrate its ability to operate effectively in the telehealth space."

    Comments

    • Can PTAs use this ? Will home health be included?

      Posted by Pamela Ray on 3/27/2020 6:16 PM

    • Could the term “Telehealth” please be clearly defined? Thank you.

      Posted by Maryellen Diane Hood on 3/27/2020 8:39 PM

    • To the editor: the title should state: "United Healthcare Pays for Telehealth for Physical Therapy"

      Posted by 007 on 3/28/2020 3:59 AM

    • Hello I am a PT Receptionist currently working from home. Is there an up to date list of all insurances allowing Telehealth at this time of need by a licensed Physical Therapist? I assured my Boss that I would research this for him. Thank you! Carol Hopkins for Performance Physical Therapy. - Peterborough NH

      Posted by Carol Hopkins on 3/28/2020 11:06 AM

    • The link for the avaliable codes is a bad link and leads to nothing.. I'm interested in seeing that list of anyone has a link that works.

      Posted by Justin Smith on 3/28/2020 11:54 AM

    • Will insurances allow home health therapists to bill telehealth, or is home health still required to be in person?

      Posted by Catherine Bookser-Feister on 3/30/2020 9:43 AM

    • does this work for all providers of therapy including hospital based outpatient

      Posted by MARY on 3/30/2020 10:37 AM

    • Do you know if this applies to UHC medicare advantage plans as well or just standard UHC plans?

      Posted by Jason Sellers on 3/30/2020 12:54 PM

    • @Maryellen: The answer to the definition of telehealth can be found here http://www.apta.org/PTinMotion/News/2020/03/18/E-VisitFAQs/.

      Posted by APTA staff on 3/30/2020 4:32 PM

    • @Carol: Yes, the list can found here http://www.apta.org/Telehealth/, under Check on the Status of Payers That Cover Telehealth

      Posted by APTA staff on 3/30/2020 4:32 PM

    • @Justin: please try again--we checked and it's working for us. But if you're still having problems, you can find a link on the UHC page on the change: https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/covid19-telehealth-services/covid19-telehealth-pt-ot-st.html

      Posted by APTA staff on 3/30/2020 4:34 PM

    • Hello, do we know what billing guidelines to follow for united health care for example[ what modifier ,cpt codes, and pos] we will need for billing? Thank you

      Posted by Katherine on 4/2/2020 12:44 PM

    • Hello I own a 1 Phyisical Therapy Out Pt. clinic. I was wondering am I allowed to be a alternate care site for telemedicine? I would plan to offer a telemedicine computer site for well pt. visits to any of their doctors. This would decrease travel distances for the elderly or disabbiled or any individuals in my community. These individuals most likely would not have a computer with camera of modern cell phone to otherwise acess telemedicine. I would set up my facility up for one patient at a time and with Infection controls meassures. Would I be allowed to bill for this service? Sincerely Alicia Ebersole,

      Posted by Alicia ebersole on 4/2/2020 2:28 PM

    • Are PT's allowed to perform initial evaluations via telehealth and/or e-visits, or do these services only apply to "established" patients.

      Posted by Misty on 4/3/2020 11:24 AM

    • @ Mary: We're waiting on clarification from UHC as to how these claims can be billed on a UB04.

      Posted by APTA staff on 4/4/2020 11:22 AM

    • @ Katherine: UnitedHealthcare will reimburse eligible codes when submitted with a place of service code 02 and modifier 95.

      Posted by APTA staff on 4/4/2020 11:23 AM

    • @Misty: Response: Initial evaluations cannot be provided via e-visits. United Healthcare has included the physical therapy evaluation codes as codes that may be billed via telehealth. This varies by payer so please check the resources at the link below to see if a specific payer is allowing for the evaluation codes to be billed via telehealth. http://www.apta.org/Telehealth/

      Posted by APTA staff on 4/4/2020 11:23 AM

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