Payment Advocacy Win for APTA and APTA Private Practice

United Healthcare has published an updated Habilitative Services policy that eliminates ambiguity regarding required "time-in and time-out" documentation. The Payer has made the following change in their policy:

Treatment Session Notes

Replaced “start and stop time in treatment” with “accurate documentation of the length of treatment session"

The new policy states the following requirements for claim submission:

Treatment Session Notes

All treatment session notes must include:

• Date of treatment
• Specific treatment(s) provided that match the CPT code(s) billed
• Accurate documentation of the length of treatment session
• The individual’s response to treatment
• Skilled ongoing reassessment of the individual’s progress toward the goals
• All progress toward the goals in objective, measurable terms using consistent and comparable methods
• Any problems or changes to the POC
• Member or caregiver involvement in and feedback about home program activities
• Signature and date of the treating provider

Thank you to all APTA Private Practice members who advocated with the payer for the change!