Community Plan Reimbursement Policies of Louisiana
For policies listed below that do not apply to UnitedHealthcare Community Plan Medicare products, as indicated in the Application section of each policy, please refer to the UnitedHealthcare Medicare Advantage Reimbursement Policies for further information.
Current Policies
Community Plan Reimbursement Policies Terms and Conditions
Please read the terms and conditions below carefully.
Important Note about Reimbursement Polices
All provider notification regarding UnitedHealthcare Community Plan reimbursement and medical policies will be posted on this website.
The UnitedHealthcare Community Plan Reimbursement policies are generally based on national reimbursement determinations, along with state government program reimbursement policies and requirements. Please note that where a specific conflict between a provision of a contract between UnitedHealthcare Community Plan and an applicable state program a provider contracts or state/federal regulations, such contract/regulation will supersede these reimbursement policies.
Important Policy Note
You are responsible for submission of accurate claims requests. This reimbursement policy is intended to ensure that you are reimbursed based on the code that correctly describes the procedure performed. This and other UnitedHealthcare Community Plan reimbursement policies may use CPT, CMS or other coding methodologies from time to time. References to CPT or other sources are for definitional purposes only and do not imply any right to reimbursement. This reimbursement policy applies to all professionals who deliver health care services. Coding methodology, industry standard reimbursement logic, regulatory requirements, benefits design and other factors are considered in developing reimbursement policy.
This information is intended to serve only as a general reference resource regarding UnitedHealthcare Community Plan’s reimbursement policy for the services described and is not intended to address every aspect of a reimbursement situation. Accordingly, UnitedHealthcare Community Plan may use reasonable discretion interpreting and applying this policy to services being delivered in a particular case. Further, the policy does not cover all issues related to reimbursement for services rendered to UnitedHealthcare Community Plan enrollees as legislative mandates, the physician or other provider contract documents, the enrollee’s benefit coverage documents, and the Physician Manual all may supplement or, in some cases, supercede this policy. Finally, this policy may not be implemented in exactly the same way on the different electronic claim processing systems used by UnitedHealthcare Community Plan due to programming or other constraints; however, UnitedHealthcare Community Plan strives to minimize these variations.
UnitedHealthcare Community Plan may modify this reimbursement policy from time to time by publishing a new version of the policy on this website; however, the information presented in this policy is believed to be accurate and current as of the date of publication.
By clicking "I Agree," you agree that you have read and understood the UnitedHealthcare Community Plan reimbursement policy.
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Add-On Codes Policy, Facility for Louisiana - Reimbursement Policy - UnitedHealthcare Community Plan open_in_new
Last Published 01.08.2025
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Add-On Codes Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 12.09.2024
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Adjunct Services Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Plan open_in_new
Last Published 07.05.2023
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After Hours and Weekend Care Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 05.27.2025
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Age to Diagnosis Code & Procedure Code Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 04.21.2025
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Ambulance Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.02.2024
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Anesthesia Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.17.2024
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Appropriate Patient Discharge Status for Type of Bill Policy, Facility for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Assistant-at-Surgery Services Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.15.2024
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Audiologic/Vestibular Function Testing Policy for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 01.12.2024
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B Bundle Codes Policy, Professional for Louisiana- Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Bilateral Procedures Policy, Facility for Louisiana- Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Bilateral Procedures Policy, Professional for Louisiana- Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.14.2022
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Care Plan Oversight Policy, Professional for Louisiana- Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 10.25.2024
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CCI Editing Policy for Louisiana, Professional and Facility - Reimbursement Policy - UnitedHealthcare Community Plan of Louisianaopen_in_new
Last Published 03.09.2025
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Clinical Diagnostic Lab Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.25.2024
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Clinical Laboratory Improvement Amendments (CLIA) ID Requirement Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 10.10.2023
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Co-Surgeon / Team Surgeon Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.14.2022
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Contrast and Radiopharmaceutical Materials Policy, Professional and Facility for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 05.01.2024
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Drug Testing Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.25.2024
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Durable Medical Equipment, Orthotics and Prosthetics Policy, Professional (Louisiana Only) - UnitedHealthcare Community Planopen_in_new
Last Published 03.11.2024
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Facility Billing Policy for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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From-To Date Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.24.2025
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Global Days Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.14.2024
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Inappropriate Primary Diagnosis Codes Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.17.2025
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Increased Procedural Services Policy, Professional for Louisiana- Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Injection and Infusion Services Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 10.06.2024
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Injections into the Tendon Sheath and Ligament, Ganglion Cyst, Carpal and Tarsal Tunnel Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 12.10.2024
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Intraoperative Neuromonitoring Policy Louisiana Only, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.05.2024
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Laboratory Services Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.03.2024
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Maximum Frequency Per Day Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 10.08.2024
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Medically Unlikely Edits (MUE) Policy, Professional and Facility for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 01.03.2025
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Microsurgery Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.05.2024
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Modifier SU Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Mohs Micrographic Surgery Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 10.06.2024
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Multiple Procedure Payment Reduction (MPPR) for Medical and Surgical Services Policy, Professional (Louisiana Only)open_in_new
Last Published 02.02.2024
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National Drug Code (NDC) Requirement Policy, Professional and Facility (Louisiana Only)open_in_new
Last Published 11.06.2024
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New Patient Visit Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Non Covered and Covered Codes Policy, Facility (Louisiana Only) - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 04.27.2025
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Non Covered and Covered Codes Policy, Professional (Louisiana Only) - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 05.22.2025
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Non-Physician Health Care Professionals Billing Evaluation and Management Codes Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Observation Care Evaluation and Management Codes Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.28.2024
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Observation Services Policy, Facility for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.26.2024
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Obstetrical Services Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Plan open_in_new
Last Published 02.05.2024
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Obstetrical Ultrasound Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Plan open_in_new
Last Published 02.05.2024
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Once in a Lifetime Procedures Policy, Professional (Louisiana Only) - UnitedHealthcare Community Planopen_in_new
Last Published 04.15.2024
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Orthotics (L3000) Policy, Professional for Louisiana - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Otoacoustic Emissions Testing Policy, Professional for Louisiana - UnitedHealthcare Community Planopen_in_new
Last Published 11.15.2024
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Pediatric and Neonatal Critical and Intensive Care Services Policy, Professional for Louisiana - UnitedHealthcare Community Planopen_in_new
Last Published 01.12.2024
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Physical Medicine & Rehabilitation: PT, OT, and Evaluation & Management Policy, Professional for Louisiana - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Physical Medicine and Rehabilitation Maximum Combined Frequency Per Day Policy Professional for Louisiana - UnitedHealthcare Community Planopen_in_new
Last Published 11.14.2022
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Preventive Medicine and Screening Policy for Louisiana - UnitedHealthcare Community Planopen_in_new
Last Published 02.02.2024
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Procedure to Modifier Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 09.16.2024
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Procedure to Place of Service Policy, Professional for Louisiana - Reimbursement policy - UnitedHealthcare Community Planopen_in_new
Last Published 03.09.2025
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Professional/Technical Component Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.20.2024
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Provider Preventable Conditions: Health Care Acquired Conditions and Present on Admission Policy, Facility for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Radioallergosorbent (RAST) Type Tests Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 01.12.2024
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Rebundling Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.17.2024
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Reduced Services Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Revenue Codes Requiring Procedure Code Policy, Facility for Louisiana - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Robotic Assisted Surgery Policy for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Same Day/Same Service Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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Services and Modifiers Not Reimbursable to Health Care Professionals Policy, Professional for Louisiana- Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.14.2022
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Standby Services Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.23.2022
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T Status Codes Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 01.11.2024
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Telehealth/ Virtual Health Policy, Professional (Louisiana Only) - UnitedHealthcare Community Plan of Louisianaopen_in_new
Last Published 05.23.2025
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Unlisted Services Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Plan open_in_new
Last Published 02.16.2024
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Vaccines For Children Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 06.20.2023
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Vitamin D Testing Policy, Professional for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 11.17.2024
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Wrong Surgical or Other Invasive Procedures Policy, Professional and Facility for Louisiana - Reimbursement Policy - UnitedHealthcare Community Planopen_in_new
Last Published 02.02.2024
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