United Health Care 45 vs 60 Minute Session Policy
Just a quick post about United Health Care, Optum, and United Behavioral Health Plans and how they are handling CPT codes 90834 vs 90837.
All Optum, UBH, and UHC plans will automatically approve CPT code 90834 (45 – 55 minute individual therapy sessions) without authorization.
But you’ll now need to obtain authorization for individual sessions that are longer than 55 minutes using CPT code 90837.
So you can call (800) 888-2998 to obtain authorization for those sessions. They will limit the number of sessions with that CPT code and also provide you a unique “authorization number” that you’ll need to include on your CMS1500 form when filing claims.
We’re happy to help with the process anytime so drop us a line to talk about our mental health billing service.
This is just one more barrier for people who need mental health services. Ugh
Requiring pre-authorization for this billing code is as blatant a violation of Mental Health Parity as there is!! I was informed by UBH that they only pay the 90837 code for specific diagnoses (if i remember correctly, PTSD and BPD). I spoke with an attorney who specializes in Health Insurance and he clarified that this was a violation, and that UBH is well known for consistently violating parity laws. The problem is that they will continue to do this until they are forced to stop. We should find a way for therapists to come together and fight this issue!!
Their stringent & very limited requirements for a 90837 is obviously a way to avoid re-imbursement!