United HealthCare T Status Codes Policy (2021)

“There are RVUs and payment amounts for these services, but they are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider. If any other services payable under the physician fee schedule are billed on the same date by the same provider, these services are bundled into the physician services for which payment is made.”

Consistent with CMS, UnitedHealthcare considers Current Procedural Terminology (CPT®) and Healthcare Common Procedural Coding System (HCPCS) codes with a status indicator of T bundled into any other service provided, on the same date by the same individual physician or other health care professional, for which payment is made. No modifier overrides will exempt T status codes from bundling into the services for which payment is made.

In the case of two T status codes being billed together with no other service, on the same date of service by the same individual physician or other health care professional, UnitedHealthcare will bundle the code with the lower relative value unit (RVU) into the code with the higher RVU.

T Status Codes

36598 Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report

94760 Noninvasive ear or pulse oximetry for oxygen saturation; single determination

94761 Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)

96523 Irrigation of implanted venous access device for drug delivery systems

G0117 Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist

G0118 Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist

For more information on rebundling edits, refer to the UnitedHealthcare “Rebundling Policy.”