UnitedHealthcare (UHC) has announced important updates to its anesthesia reimbursement policy, effective October 1, 2025 (Ohio effective November 1, 2025).
Below is a summary of the key changes:
UHC will implement a 15% reduction in reimbursement for Certified Registered Nurse Anesthetist (CRNA) services billed with modifier QZ. This change applies to UHC Commercial and Exchange plans, excluding Arkansas, California, Colorado, Hawaii, Massachusetts, New Hampshire, and Wyoming.
Additionally, UHC will no longer include physical status modifiers (P3, P4, P5) and qualifying circumstance codes (99100, 99116, 99135, 99140) in anesthesia reimbursement calculations. These updates align with CMS methodologies and aim to standardize CRNA reimbursement with other advanced practice providers.
Anesthesia Resources will continue to apply appropriate modifiers based on services rendered for accurate coding and billing of UHC Commercial and Exchange plan claims.
Download the Commercial Reimbursement Policy Update Bulletin