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UnitedHealthcare to implement new drug testing reimbursement policy



June 28, 2017
Area(s) of Interest: Commercial Payors 

UnitedHealthcare has advised that it will implement a new drug testing reimbursement policy for commercial members effective for dates of service on or after September 1, 2017. The new policy will only allow one Presumptive Drug Class procedure per drug class (codes 80305, 80306 and 80307) per member, per date of service, whether submitted by the same or different provider. The policy will also only allow one Definitive Drug Class procedure per drug class (codes G0480, G0481, G0482, G0483 and G0659) per member, per date of service, whether submitted by the same or different provider. 

Per the Centers for Medicare and Medicaid Services regulations, providers performing validity testing on urine specimens utilized for drug testing cannot separately bill for validity testing. In alignment with this regulation, UnitedHealthcare will not separately reimburse for urine validity testing.

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