Announcement

UHC to cover H1N1 immunization administration and Rapid Flu Tests

The information below that recently (8/27/09) went out to the pediatric councils regarding UHC and issues related to H1N1.

Greetings!

In an email from Mia Rosenberg, UHC External Provider Relations, two updates were provided on UHC payment for rapid flu tests and coverage for H1N1 influenza immunization administration.

The AAP has been contacting the largest national private health plan carriers regarding coverage for the H1N1 influenza immunization administration. Of the responses received, the major plans will cover the immunization administration for those with immunization benefits. UHC will also provide coverage for H1N1 influenza immunization administration also for those plan members that do not have immunization benefits coverage.

Rapid Flu Test fee increase:

Effective for dates of services on or after October 1, 2009, UnitedHealthcare is implementing a physician fee increase for the Rapid Flu Test for many physicians. This increase is prompted by the anticipated increase in utilization of the Rapid Flu Test, Current Procedural Terminology® code 87804. The update includes reclassification of the Rapid Flu Test from the "clinical laboratory" to the "office lab" type of service, a category that includes lab tests commonly performed in the physician office setting. Reclassification of the Rapid Flu Test to the office lab type of service will increase that fee for many physicians.

In addition to the reclassification described above, some physicians may also receive an increased fee above the office lab type of service amount for the Rapid Flu Test as a result of our research on a reasonable payment for the Rapid Flu Test for physicians.

Please call your local Network Management representative if you have any questions regarding your fee for the Rapid Flu.

The press release can be found by visiting <http://www.unitedhealthgroup.com/

Louis A. Terranova, MHA
Senior Health Policy Analyst
Private Payer Advocacy
Department of Practice
American Academy of Pediatrics
141 Northwest Point Blvd.
Elk Grove Village, IL 60007
800/433-9016 ext. 7633
847/434-7633
Fax: 847/228/9651
E-mail: lterranova@aap.org