United Healthcare Agrees to Delay Lab Billing Requirement

November 4, 2020

United Healthcare (UHC) announced it will delay implementation of a controversial hospital lab billing policy until April 1, 2021. UHC had notified hospitals of a new requirement that they register and bill hospital lab services to UHC using hospital-specific lab codes, rather than the standard CPT codes required by CMS and other carriers. The proposed policy was to go into effect in December. The American Hospital Association and hospitals are challenging the new policy due to significant implementation costs during the COVID-19 emergency.  Hospitals believe the policy also conflicts with HIPAA provisions regarding standard billing codes, forcing hospitals to build and maintain separate billing infrastructure for UHC claims. While UHC agreed to the delay, it has not indicated that it plans to withdraw the proposal. (Andrew Busz, AndrewB@wsha.org)


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