UnitedHealthcare will reimburse appropriate claims for telehealth services in accordance with the member’s benefit plan. Depending on whether a claim is for a UnitedHealthcare Medicare Advantage, Community Plan or commercial plan member, those policies may have different effective dates and telehealth requirements for a claim to be reimbursed.
Effective with dates of service on and after Jan. 1, 2021, UnitedHealthcare will modify the Telehealth and Telemedicine Policy, including the following:
Telehealth services must be rendered using live, interactive audio and video visits and recognized by:
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Effective Jan. 1, 2021 certain UnitedHealthcare Medicare Advantage plans will allow certain Centers for Medicare & Medicaid (CMS)-eligible telehealth services when billed for members at home. For plans with this telehealth benefit, details will be outlined in the member’s Evidence of Coverage (EOC) and other plan benefit documents.
Outside of the originating site requirements for plans with the additional benefit, we'll follow the current CMS telehealth code list and billing requirements.
For UnitedHealthcare Community Plans, we’ll continue to follow state regulations and guidelines regarding telehealth services and reimbursement. If no state guidance is provided, UnitedHealthcare guidelines will apply, if appropriate.