On Aug. 1, UnitedHealthcare implemented a new policy on Services Incident-to a Supervising Health Care Provider. This new policy addresses the ACR’s concerns regarding the payer’s Advanced Practice Healthcare Provider policy and allows for appropriate reimbursement for “incident-to” services consistent with current Medicare guidelines.
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In March of this year, UHC made changes to its Advanced Practice Healthcare Provider policy, limiting the ability of Advanced Practice Providers (APPs) to bill for services provided “incident-to” a physician’s services and instead requiring them to bill under their own National Provider Identifier number. These services would then be reimbursed at 85% of the contracted fee schedule.
The ACR, along with numerous other provider organizations, expressed serious concerns about the impact of this policy change on rheumatology practices and the threat it posed to patients’ timely access to treatment. We applaud UHC for hearing these concerns and responding with a new policy that recognizes and ensures practices’ ability to bill for “incident-to” services with criteria that are consistent with current Medicare guidelines.
The ACR continues to monitor this issue and we encourage members to contact [email protected] with any questions or concerns.