UnitedHealthcare – Reimbursement Policy Update Bulletin: Effective October 1, 2024

Professional/Technical Component Policy, Professional

October 1, 2024

• UnitedHealthcare will enhance the Professional/Technical Component Policy, Professional to align with the Centers for Medicare and Medicaid (CMS): if a radiology service is rendered and the physician or other eligible qualified healthcare professional performs a review rather than the full written interpretation and report, the reimbursement is considered included in the Evaluation and Management (E/M) service.
• The interpretation of a radiology service appended with modifier 26 will not be considered for separate reimbursement when reported on the same date of service as an E/M service unless a copy of the radiology report is attached to support separate reimbursement.

Source: https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-reimbursement/rpub/UHC-COMM-RPUB-July-2024.pdf