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RPRC Committee Urges UnitedHealthcare to Reconsider Policy Change

Nov 04, 2016

As previously communicated, AAPM&R's RPRC committee submitted a letter to UnitedHealthcare regarding a payment policy implemented in the second quarter of 2016 that inappropriately applies the CMS payment adjustment methodology for bilateral eligible procedures to add-on codes. The Academy urged UnitedHealthcare to reconsider this policy change and recognize that all add-on codes are exempt from the multiple procedure reduction concept. In response, UnitedHealthcare agreed with the Academy and clarified that they do not intend to apply multiple procedure reductions to those codes. Implementation of this policy was also delayed to the third quarter of the year.