Starting Sept. 1, UnitedHealthcare (UHC) will implement five new payment policies impacting if and how physicians get paid to screen for or monitor certain conditions.
Carra Benson, director of the Texas Medical Association’s Physician Payment Resource Center (PPRC), notes that such a high volume of new payment policies effective in the same timeframe is uncommon. Physicians should assess how these policies could impact their payment while ensuring they follow billing best practices, she adds, and TMA’s PPRC can help with questions.
Four of the five new policies will allow physicians to get paid for delivering and monitoring treatment for certain illnesses or for running specific tests, including:
- In vitro allergy testing to screen certain patients for moderate to severe asthma and other conditions;
- Hepatic fibrosis testing for chronic liver diseases;
- Certain tests and treatment monitoring for prostate cancer, testicular hypofunction, and other conditions potentially necessitating hormone treatment; and
- Testing identifying a vitamin B-12 deficiency.
Each of those four policies also detail circumstances that would make those services unpayable, as well as which tests physicians will not get paid for providing. For instance, per the policies, UHC will not pay physicians for:
- Some other allergy tests, including depending on test type;
- Multianalyte assays related to liver disease testing; and
- Certain hormone tests and treatments for asymptomatic patients or patients with non-specific symptoms.
An additional fifth new policy mandates that physicians will not receive any payment for certain chemotherapy testing.
Need help with coding or payers? Call TMA’s PPRC at 512-370-1414.
Last Updated On
June 10, 2026
Originally Published On
June 10, 2026
Alisa Pierce
Reporter, Division of Communications and Marketing
(512) 370-1469