UnitedHealthcare announced an update to its Professional/Technical Component Policy that will affect reimbursement for radiology services billed alongside evaluation and management (E/M) services beginning for dates of service on or after April 1.
Starting April 1, when the same provider bills an E/M service and a global radiology code for the same patient on the same date, UnitedHealthcare will require a full written interpretation and report to separately reimburse the professional component of the radiology service. If no written report is submitted, the professional component of the global radiology code will not be reimbursed separately, and time spent reviewing the radiology images will be bundled into the payment for the E/M service.
The interpretation report must also be consistent with American College of Radiology guidelines. If the radiology service and the E/M service are billed by different providers, a separate report submission is not required for reimbursement, although documentation should still be maintained in the medical record.
UnitedHealthcare notified impacted providers of this change in an issue of their Network News under reimbursement policy updates on January 2. APMA will continue to monitor this change and share additional guidance as needed.