Wiki UnitedHealthcare nonphysician billing "incident to" guidelines for commercial plans

[ellzeycoding]

UnitedHealthcare nonphysician billing "incident to" guidelines for commercial plans

I am looking for guidelines for UnitedHealthcare Commercial insurance (not Medicare or Medicare Advantage).

I'd like to see if there is an official "incident to" policy for PAs and NPs billing under supervising providers vs. NP/PAs billing under their own number when unsupervised.

I can only seem to find the UHC policy for their Medicare-related plans.

Web-links are appreciated.

 

[BillingAdvocate]

Hi Karl,

You might have found your answer by now. In case you haven't, on 5/10/17 United approved policy 2017R6004A (Advanced Practice Provider Evaluation and Management Procedures Policy) for its Commercial policies. It was implemented on 9/1/17. I have attached a copy for your reference.

Hope that helps!

Sharon Gall, CPC

 

[jplg55]

JP Griffin, MS CPC

Hi Karl. Did you ever find specific "incident-to guidelines" for UHC Commercial Products? I have been search for months and have had no success. The Sept 2017 document form UHC re: modifier SA does not mention how to find UHC incident-to guidelines. MY UHC Account Rep is less than helpful so I am hoping that you can provide what you have discovered! Thanks, JP Griffin MS CPC (COO, Hibiscus Women's Center PA).

 

[ellzeycoding]

I was never able to find anything other than their SA policy. I believe this is only used when the NP/PA isn't credentialed through UHC directly.

Outside of that I never discovered anything else or came across any other published policy