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United Healthcare to delay implementation of multiple procedure payment reductions until March 1

December 04, 2015
Area(s) of Interest: Payor Issues and Reimbursement 


In its December 2015 Network Bulletin, United Healthcare (UHC) announced that the multiple procedure payment reductions scheduled to begin with November 15, 2015, dates of service have been delayed until March 1, 2016.


UHC previously announced in August that it would begin applying multiple procedure payment reductions to the following services:



  • Technical component of diagnostic cardiovascular and ophthalmology procedures

  • Professional component of diagnostic imaging services

  • Some endoscopy procedures


According to UHC, the new claim edits will apply for UHC commercial claims and that it is implementing the reductions to better align with the Centers for Medicare and Medicaid Services.


Questions about any of the claims editing rules or payment policies can be directed to UHC at (877) 842-3210.

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