The NYSCA Officers thank the insurance committee for their work in continuing this conversation and assisting in bringing more options to New York's chiropractors and chiropractic patients. Updates to the United HealthCare policies allowing chiropractors to utilize telemedicine services to care for their patients is below.
The NYSCA continues to interact with health plans to bring you the most up to date information relative to telehealth services. We understand the challenges each of you face as you continue to offer the best solutions to your patients. Please note that UnitedHealthcare has updated their telehealth policy on April 5, 2020. Links to UHCProvider are listed below. As of April 6, 2020, the updated policy reads as follows (emphasis added):
Chiropractic Therapy
UnitedHealthcare will reimburse telehealth services submitted by chiropractors when provided by qualified health care professionals and rendered using interactive audio/video technology for Medicaid, and Individual and fully insured Group Market health plan members. Medicare Advantage coverage limitations still apply, as well state laws and regulations. Benefits will be processed in accordance with the member’s plan.
Cost sharing will be waived for in-network telehealth visits for chiropractic services for Medicaid, Individual and fully insured Group Market health plan members, with opt-in available for self-funded employers.
This change is effective for dates of service from March 18, 2020 until June 18, 2020.
Reimbursable codes are limited to the specific set of codes listed here. UnitedHealthcare will reimburse eligible codes on a CMS 1500 form using the place of service that would have been reported had the services been furnished in person along with a 95 modifier, or on a UB04 form with revenue code 780.
Link to the above notice can be found here.
Please also note that:
Chiropractic Reimbursement
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UnitedHealthcare will not reimburse providers for audio-only visits. All visits must be performed using live video-conferencing that involves the presence of both parties at the same time and a communication link between them that allows a real-time audio and visual interaction to take place. E-mailing “stored” exercise videos and discussing or reviewing by phone is not reimbursable. Providers must always comply with the requirements of the state that issues their license in providing services.
Technology Requirements
All visits must be performed using live video-conferencing that involves the presence of both parties at the same time and a communication link between them that allows a real-time audio and visual interaction to take place.
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For Individual and fully insured Group Market health plan members, UnitedHealthcare follows CMS standards for technology. The U.S. Department of Health and Human Services Office for Civil Rights (OCR) is exercising enforcement discretion and waiving penalties for HIPAA violations against health care providers that serve patients in good faith through everyday communications technologies.
The NYSCA recognizes the efforts taken by UnitedHealthcare to assist patients in accessing this important benefit. Please take the time to review the above information directly on UnitedHealthcare’s web portal, www.UHCProvider.com. Note that information is frequently updated. Periodic verification will ensure you have the most up to date information.
Be safe, be well, help those that you can, and continue to minimize risk.
Your dedicated partners,
The NYSCA Insurance Committee
