United Healthcare Oxford - Consultation Services (99241-99245) & (99251-99255)

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  • Oxford has changed the reimbursement policy for Consultation services 99241-99245 and 99251-99255 effective 10/01/2019.
  • These services cannot be reimbursed effective 10/01/2019 and need to use replacement CPT codes.
  • This Oxford policy is not applied to the Medicare advantage plan, it is applied to Oxford commercial plan only.
  • Oxford has added replacement codes ranging from 99446-99452.
  • If you are getting denial for such Consultation services then assign it to the coding team for the correct replacement code and notify the client to stop billing these services to Oxford and use replacement codes.
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2 comments:

  1. Anonymous20 January 2025 at 04:08

    however to identify though member ID, What plan patient has OPTUM Plan ,UHC plan OR UMR plan?

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    Replies
    1. ARLearning Team1 February 2025 at 07:53

      Please check the table in the below post. You will find the insurances with their policy ID format. This will help you to identify the insurance through member ID.

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