COVID-19 Testing, Treatment, Coding & Reimbursement

COVID-19 Testing, Treatment, Coding & Reimbursement



Testing, coding and reimbursement protocols and guidelines are established based on guidance from the Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), state and federal governments and other health agencies. We’re closely monitoring COVID-19-related updates from these partners and updating this site as quickly as possible when new information is available. Care providers should work with local and state health departments to coordinate testing.

 

COVID-19 Testing Guidance

 

During the national public health emergency period, UnitedHealthcare will cover medically necessary COVID-19 testing at no cost share when ordered by a physician or appropriately licensed health care professional for purposes of the diagnosis or treatment of an individual member.*

 

Tests must be FDA authorized to be covered without cost sharing (copayment, coinsurance or deductible). FDA-authorized tests include tests approved for patient use through pre-market approval or emergency use pathways, and tests that are developed and administered in accordance with FDA specifications or through state regulatory approval.

 

This coverage applies to members enrolled in Medicare Advantage, Medicaid and Individual and Group Market health plans. Benefits will be otherwise adjudicated in accordance with the member’s health plan. State variations and regulations may apply during this time.

 

UnitedHealthcare is requesting all physicians and health care professionals who perform and bill for COVID-19 antibody tests to register the test(s) that will be used for our members.

 

*Licensure requirements vary by state. In some states, a pharmacist or other health care professional, such as a nurse practitioner, may have the appropriate licensure to order a test. Please refer to state-specific licensure requirements for appropriate guidance.

 

Date Reference Guide: Keep track of which temporary measures are expiring and which are being extended with our Summary of COVID-19 Dates by Program.

 

Continued Support: We are committed to business continuity and being there to assist you. All self-service capabilities are available, our call center is staffed and claims are being processed so you have the support you need.

 

-Testing and Cost Share
-Treatment and Cost Share
-Claim Coding, Submissions and Reimbursement

 

 

Resources

 

Care providers can connect to the latest Centers for Disease Control and Prevention (CDC) guidance for health professionals, as well as travel advisories from the U.S. State Department.

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