UnitedHealthcare has published formal written guidance on a policy change it announced last fall that impacts providers working with UHC commercial and individual exchange plans. In November 2023, UHC eased a provision requiring PTs to document start and stop times for each follow-up session, saying that the requirement could be met by providing total treatment time. However, UHC stopped short of providing formal language on the provision.
In July, the insurer released the written guidance in an updated policy, which clarifies what is meant by documenting “treatment time.” The policy states that “Accurate documentation of the length of the treatment session” must be included in treatment session notes.
The clarification applies to benefit plans that have a medical necessity requirement for habilitation, rehabilitation, and maintenance therapies.
The full set of management guidelines, which includes the requirement for documenting length of treatment, is available for review online. UHC encourages providers to reach out to UHC Provider Services, their provider advocate, or a network representative with questions.
(Be sure to stay on top of provider policies. Regularly review the UnitedHealthcare Administrative Guide and other resources available on the UnitedHealthcare provider portal.)