Reimbursement

United Focuses on Hospital Outpatient Imaging

February 15, 2019

United Focuses on Hospital Outpatient Imaging

Starting March 1, 2019, United Healthcare will review whether the site-of-care is appropriate for certain magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and computed tomography (CT) procedures performed in hospital outpatient departments.
 

United will do the review as part of prior authorization requests, but will not review the site-of-care for procedures performed in a free-standing diagnostic radiology center or a physician’s office.

  • The new policy does not apply in  Alaska, Connecticut, Iowa, Kentucky, Maine, Utah, Vermont, or Wisconsin.
  • Also, prior authorization is not required for advanced outpatient imaging procedures done in an emergency room, urgent care center, or observation unit, or during an inpatient state.


The new United policy is similar to that of Anthem Blue Cross and Blue Shield announced in 2017.
 

View United Policy