RPRC Committee Urges UnitedHealthcare to Reconsider Policy Change

Members & Publications


November 4, 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. 

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.