Modeled after the multiple procedure payment reduction policy implemented by the Centers for Medicare and Medicaid Services, UnitedHealthcare (UHC) will implement a new multiple therapy reduction policy on physical medicine and rehabilitation services effective March 1, 2012. The October 2011 OptumHealth physical health provider newsletter provides details on the multiple therapy reduction policy, which will apply to UHC claims only. UHC's intent is to use the code with the highest practice expense value as the primary procedure. OptumHealth is evaluating the policy and will notify its providers in a future newsletter if it will be implemented in OptumHealth systems. The policy does not apply to providers contracted at a flat rate per diem payment methodology.
OptumHealth's physical health provider newsletter is available online for contracted providers through its member-protected Web site. The bulletin will be available online in November through UHC's Web site and will be accessible to providers both in and out of network (OON). This will give OON providers advanced notice prior to implementation.
APTA will submit a letter of comment to UHC.