UnitedHealthcare: Policy and Service Area Changes

Service Area Changes for UnitedHealthcare Medicare Advantage 2023 

From January 1, 2023, UnitedHealthcare will discontinue some plans. The notice also states that there will be changes to some Medicare Advantage service areas. These changes may impact some patients. As a matter of fact, UnitedHealthcare will send non-renewal notices to the affected patients on or before October 2, 2022, to let them know about the changes.  

However, the majority of health care professionals and facilities contracted for UnitedHealthcare Medicare Advantage plans will face no impact.  

Source:https://www.uhcprovider.com/en/resource-library/

Policy Changes Effective from December 1, 2022 

United Healthcare will change the name of ‘Reduced Services Policy, Professional’ to “Modifier Reduction Policy, Professional” from December 1, 2022. Summary of the changes are enumerated below:

• United Healthcare will add modifiers CT FX and FY to this update. 
• United Healthcare will reduce the allowed amount of the technical component of a CPT/HCPCS when the following modifiers are submitted on a professional claim.  
• Modifier CT will result in a 15% reduction for dates of service on and after December 1, 2022. 
• Modifier FX will result in a 7% reduction for dates of services on 1st December and then a 10% reduction beginning January 1, 2023. 
• Modifier FY will follow the changes like the modifier FX.  

Source: https://www.uhc.com/