Insurance

Correction: United to Require GP Modifier as of Sept. 1, 2019

United Healthcare has delayed the requirement to append the GP modifier to any codes that are deemed “Always Therapy” codes, according to CMS, until September 1, 2019. 

The delay was announced on their website here.  The policy change was also formally re-announced in the July 2019 United Network Bulletin (page 32).  United also sent a follow up letter to providers with the latest dates and information.  A copy of this letter can be viewed  here .

All claims sent to any and all United plans on or after date of service 9/1/2019 should append the GP modifier to the following codes: 97012, 97016, 97018, 97022, 97024, 97026, 97028, 97032, 97033, 97034, 97035, 97036, 97039, 97110, 97112, 97113, 97116, 97124, 97139, 97140, 97150, 97530, 97533, 97535, 97537, 97542, 97750, 97755, 97760, 97761, 97762*, 97799, G0281, G0283. 

You should only use the GP modifier on United Healthcare claims per their policy.  You should not begin using the GP modifier on other commercial carriers unless that carrier directs providers to do so.  This should not effect reimbursement, cost-sharing or services allowed.