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April 2018

UAW Retiree Medical Benefit Trust (URMBT) clinic outpatient facility fees will no longer be reimbursed

Bundled payments previously made for outpatient services will no longer include fees for clinic visits (revenue codes 0510 to 0519) for UAW Retiree Medical Benefit Trust members with Medicare primary coverage. This change is the result of an audit where we identified that these fees were paid in error based on the customer’s benefits.

While we don’t plan to recover previous payments for these codes, effective Jan. 1, 2018, these services will be denied as a non-covered benefit.

Claims affected by this change include group numbers 71400, 71434, 71435, 71472 and 71436.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.
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