Update on FLR for UHC Medicare Advantage Plans

I wanted to share a quick update regarding UHC’s functional limitation reporting policy for its Medicare Advantage plans.  As noted in my previous blog entry, UHC had announced in its May Network Bulletin that PT and OT claims with dates of service on or after Aug. 1, 2014, would require functional G-codes and severity modifiers be appended whenever a PT or OT eval or re-eval was billed.  UHC had said the policy would be available for review “once implemented”.  As the policy was still not available online today, I called UHC for further guidance.  Per the representative with whom I spoke, the reason we are not able to access the policy or additional information is that UHC has decided to put functional reporting for its Medicare Advantage plans on hold for the time being.  He said the policy is not yet implemented and that a hold has been placed on implementation most likely until the first of the year.  He said UHC will be sending out more info possibly as early as next week and that providers should bill as usual without functional G-codes and severity modifiers pending further instructions.  He also provided me with reference #C42131108203939 regarding this issue.  Stay tuned for further updates!