![]() Although the AMA has released CPT code 87913 for detection of mutations (reporting-related testing), any claim submitted to UnitedHealthcare with this code will be denied. UnitedHealthcare health plans do not cover variant testing to detect mutations for reporting purposes, including testing authorized and/or approved (done) by the FDA to classify variants. Members are responsible for checking with their employer to see if they have elected to cover surveillance testing in 2022. They are sometimes referred to as self-funded plans. 1, 2022, Administrative Services Only (ASO) plans may elect to cover surveillance testing claims administered by a health care provider under the medical benefit plan. ASO plans are health plans through which UnitedHealthcare only adjudicates claims on behalf of the employer. Exception for Administrative Services Only plans: Effective Jan.These tests are only covered when required by applicable law and adjudicated in accordance with the member’s benefit plan. UnitedHealthcare health plans generally do not cover COVID-19 surveillance testing, which is testing used for public health or social purposes such as employment (return to workplace), education, travel or entertainment. If members receive medical services or advice for other conditions at the same time as receiving a COVID test, then cost sharing will be adjudicated in accordance with the member’s health plan and they will be responsible for any copay, coinsurance, deductible or other out-of-network costs.Please do not collect upfront payment from the member.State variations and regulations may apply during this time. We will reimburse COVID-19 testing in accordance with applicable law, including the CARES Act and UnitedHealthcare reimbursement requirements.We continue to monitor regulatory developments during emergency periods.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.Tests must be FDA-authorized to be covered without cost sharing (copayment, coinsurance or deductible).For individuals enrolled in UnitedHealthcare Community Plans, state variations and regulations may apply during this time.This coverage applies to in-network and out-of-of-network tests for Medicare Advantage, Individual and Family Plans and Individual and Group Market health plans.help in the treatment of the virus for a person.diagnose if the virus is present due to symptoms or potential exposure, or. ![]() UnitedHealthcare will cover medically appropriate COVID-19 testing during the national public health emergency period (currently scheduled to end May 11, 2023), at no cost share, when ordered or reviewed by a physician or appropriately licensed health care professional* to either:
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