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UnitedHealthcare Community Plan: September l 2020 Network Bulletin Appendix NEW YORK PAYMENT POLICY - OUTPATIENT PHYSICAL & OCCUPATIONAL SERVICES COVERED & NON-COVERED CPT CODES
Page 1 of 4
Proprietary Information of UnitedHealthcare. Copyright 2020 United HealthCare Services, Inc.
NEW YORK PAYMENT POLICY
OUTPATIENT PHYSICAL & OCCUPATIONAL SERVICES
COVERED & NON-COVERED CPT CODES
APPLICABLE CODES
Check the member benefit plan document that may supersede the Additional Considerations and Coverage Limitations
and Exclusions and Prior Authorization Requirements.
See the September 2020 Network Bulletin or for more information.
UnitedHealthcare® Community Plan
Network Bulletin Appendix
UnitedHealthcare Community Plan: September l 2020 Network Bulletin Appendix NEW YORK PAYMENT POLICY - OUTPATIENT PHYSICAL & OCCUPATIONAL SERVICES COVERED & NON-COVERED CPT CODES
Page 2 of 4
Proprietary Information of UnitedHealthcare. Copyright 2020 United HealthCare Services, Inc.
UnitedHealthcare Community Plan: September l 2020 Network Bulletin Appendix NEW YORK PAYMENT POLICY - OUTPATIENT PHYSICAL & OCCUPATIONAL SERVICES COVERED & NON-COVERED CPT CODES
Page 3 of 4
Proprietary Information of UnitedHealthcare. Copyright 2020 United HealthCare Services, Inc.
UnitedHealthcare Community Plan: September l 2020 Network Bulletin Appendix NEW YORK PAYMENT POLICY - OUTPATIENT PHYSICAL & OCCUPATIONAL SERVICES COVERED & NON-COVERED CPT CODES
Page 4 of 4
Proprietary Information of UnitedHealthcare. Copyright 2020 United HealthCare Services, Inc.
UnitedHealthcare Community Plan of New York
uhccommunityplan.com For Health Care Professionals > New York > Reimbursement Policy > Professional Non-Covered Codes Policy
CPT® is a registered trademark of the American Medical Association