Back in their June bulletin, insurance provider UnitedHealthcare (UHC) announced that, as of the new fiscal year on October 1st, they would no longer be covering consultation codes. As discussed in a previous blog, this decision meant that CPT codes 99241-99245 and 99251-99255 would no longer be eligible for UHC reimbursement, forcing practices to switch gears and attempt to cover the same sorts of patient encounters with other assorted E&M codes. The decision was hardly unprecedented seeing as the Medicare and Medicaid haven’t covered consult codes in years, but the sudden shift was still enough to present a problem for many practices.
But just in time for the new month to start and those change to go in effect, UHC published its October bulletin and announced that it would be delaying the change indefinitely. In their exact words, “In an effort to give care providers more time to adjust to potential changes in their submission of procedure codes for consultation services, UnitedHealthcare will be delaying implementation of the revisions to the Reimbursement Policy…”
The key word in this statement is “delaying.” Although UHC has not listed an official timeline for when the change will finally take effect, it is important to note that this is not a reversal of their initial policy change. The decision to eliminate consult codes from the covered list is still holding firm–it just won’t go into effect in October as initially planned.
As for what spurred UHC to postpone the change, many are pointing to the letter written by 37 physician advocacy groups shortly before the policy change was to occur. This letter outlined several reasons that the change would be detrimental to practices everywhere. Though UHC has neither confirmed nor denied that this letter had any impact on their decision, the results seem too convenient to be coincidence.