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UnitedHealthcare Medicare Advantagechiropractic and acupuncture coverageQuick reference guidePlease use this quick reference guide to easily locate important phone numbers, websites and addressesas they relate to chiropractic and acupuncture coverage for UnitedHealthcare Medicare Advantage planmembers. This guide also includes information about how these benefits are administered, and a list ofcommon CPT codes to use for claims submissions.Chiropractic and acupuncture servicesTo check: Eligibility Benefits ClaimsChiropractic and acupuncture (Medicare-covered) Phone: Call the Provider Services number on the back of the member’s ID card. Online: Sign in to Link at UHCProvider.com and click on the Link button in the top right corner.Chiropractic and acupuncture (Routine) Phone: 800-873-4575 Hours: Monday–Friday, 8 a.m.–8 p.m. Eastern TimeInteractive Voice Response, 24 hours a day Online: myoptumhealthphysicalhealth.comTo check: AuthorizationsChiropractic and acupuncture (Medicare-covered) Phone: Call the Provider Authorization number on the back of the member’s ID card. Online: Visit UHCProvider.com Prior Authorization and Notification Resources.To check: ParticipationContractual issuesChangesOffice updatesChiropractic and Acupuncture (Medicare-covered)Phone: Call the Provider Services number on the back of the member’s ID card.To review the Medicare Advantage plans that your office is contracted to accept, visit the My PracticeProfile tool on link and explore the Provider Products section: UHCProvider.com Link ProviderDemographics Details Provider Products.Chiropractic and acupuncture (Routine) Phone: 800-873-4575 Hours: Monday–Friday, 8 a.m.–8 p.m. Eastern Timecontinued

To submit claims:Chiropractic and acupuncture (Medicare-covered) Online: Sign in to Link by going to UHCProvider.com and clicking on the Link button in the top rightcorner. Then, select the Claim Submission tile on your Link dashboard. Electronic: To submit claims by Electronic Data Interchange (EDI), use payer ID 87726. Learn moreat UHCprovider.com/edi. Address: Use the Medical Claims Address on the back of the UnitedHealthcare member ID card.Chiropractic and acupuncture (Routine) Online: myoptumhealthphysicalhealth.com Address:OptumHealth Physical HealthP.O. Box 212Minneapolis, MN 55440-0212Payer ID 41161 Phone: 800-873-4575o These claims are administered by Optum Physical Healtho There are no authorizations or Utilization Management requirements for this benefitTo submit appeals and grievancesChiropractic and acupuncture (Medicare-covered) Online submissions: Sign in to Link by going to UHCProvider.com and clicking on the Link buttonin the top right corner. Then, select the claimsLink tool tile on your Link dashboard. Address: Use the Medical Claims Address on the back of the UnitedHealthcare member ID card.Chiropractic and acupuncture (Routine) Address:OptumHealth Physical HealthP.O. Box 212Minneapolis, MN 55440-0212 Phone: 800-873-4575Original MedicareChiropractic and acupuncture (Medicare-covered) Centers for Medicare & Medicaid Services (CMS): CMS.HHS.gov Medicare: Medicare.govChiropractic and acupuncture (Routine)N/APolicy guidelinesChiropractic and acupuncture (Medicare-covered)UHCProvider.com Policies and Protocols Medicare Advantage Policies Policy Guidelines forMedicare Advantage Plans Chiropractic Services – Medicare Advantage Policy Guideline Acupuncture for Chronic Lower Back Pain – Medicare Advantage Policy GuidelineChiropractic and acupuncture (Routine) Phone: 800-873-4575 Online: myoptumhealthphysicalhealth.comcontinued

Chiropractic servicesWhat’s covered?Chiropractic (Medicare-covered)Medicare covers only manual manipulation of the spine to correct subluxation.Chiropractic (Routine)Routine chiropractic is a supplemental benefit offered on some UnitedHealthcare Medicare Advantageplans that covers chiropractic services that aren’t covered under Original Medicare. This benefit allowsmembers to visit chiropractors for pain relief, neuromusculoskeletal disorders and nausea.How to find a network chiropractic providerChiropractic (Medicare-covered)You can find network care providers by searching the Chiropractic section of the online providerdirectory at the plan website listed on the back of the member’s ID card.Note: If you’re unable to locate a care provider in your area, please contact your local Network AccountManager or Physician Advocate for help. If you don’t know who to contact, go to UHCProvider.com Menu Contact Us.Chiropractic (Routine)You can find network care providers by searching the Chiropractic section of the online providerdirectory at the plan website listed on the back of the member’s ID card.Does the member require a referral to receive this service?Chiropractic (Medicare-covered)Members of referral-required plans need a referral for Medicare-covered chiropractic care.Members of open access plans don’t need a referral for Medicare-covered chiropractic care.Chiropractic (Routine)We don’t require referrals for routine chiropractic care.Member cost sharingChiropractic (Medicare-covered)See the copay listed in the Evidence of Coverage for Medicare-covered chiropractic services.Chiropractic (Routine)See the copay listed in the Evidence of Coverage for routine chiropractic services.continued

Chiropractic CPT CodesMedicare-covered: Chiropractic manipulations for subluxation*98940Chiropractic manipulative treatment; spinal (1 to 2 regions)98941Spinal (3 to 4 regions)98942Spinal (5 regions)Modifier: AT This modifier should be used when reporting service 98940, 98941, 98942 This modifier shouldn’t be used when providing maintenance therapy*For more information on Medicare-covered chiropractic services, including links to supporting policies on cms.gov,visit UHCProvider.com Policies and Protocols Medicare Advantage Policies Policy Guidelines for MedicareAdvantage Plans Chiropractic Services – Medicare Advantage Policy Guideline.Routine: Chiropractic manipulations and other services for indications other than subluxation98940Chiropractic manipulative treatment; spinal (1 to 2 regions)98941Spinal (3 to 4 regions)98942Spinal (5 regions)98943Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regionsModifier: ATRoutine chiropractic claims shouldn’t contain the AT modifierOther Routine Chiropractic Common Codes (not a complete list)Therapeutic97110Therapeutic exercise (15 minutes)97112Neuromuscular re-education97140Manual therapy (for example, myofascial release; 15 minutes)Radiology72010Spine, entire, survey study, A-P and lateral72040Spine, cervical (2 or 3 views)72070Spine, thoracic (2 views)72100Spine, lumbosacral (2 or 3 views)Durable Medical EquipmentA4565Sling (Arm)E0190Lumbar cushion/Cervical pillowL0120Cervical collar (flexible foam)L0210Thoracic (rib belt)L3332Heel liftL3908Wrist hand orthosis (wrist extension control cock-up)L3914Wrist hand orthosis, wrist extension controlCode ranges for per visit fee scheduleA4206-A9999, E0100-E0930, E0936-E2621, G0108-G0109, G0237-G0283, G0420-G0439, K0001-K0899,Q3014, S8948, 29000-29799, 36415, 70010-79999, 80047-89399, 90281-96117, 97001-97814, 9892598969, 99000-99091, 99201-99499continued

Notes: Refer to your Supplemental/Routine Fee Schedule for covered chiropractic services All codes are subject to change Please follow Original Medicare-covered indications and coding rules when billing Medicare-covered services andreview codes at cms.gov before submitting claimsAcupuncture servicesWhat’s covered?Acupuncture (Medicare-covered)Medicare covers acupuncture services for chronic low back pain only. Covered services include: Up to 12 visits in 90 days An additional 8 sessions for patients demonstrating an improvement No more than 20 acupuncture treatments may be administered annually Treatment must be discontinued if the patient is not improving or is regressingChronic low back pain is defined as: Lasting 12 weeks or longer Nonspecific, in that it has no identifiable systemic cause (i.e., not associated with metastatic,inflammatory, infectious, etc. disease) Not associated with surgery Not associated with pregnancyAcupuncture (Routine)Routine acupuncture is a supplemental benefit offered on some UnitedHealthcare Medicare Advantageplans. This benefit allows members to visit acupuncturists for pain relief, neuromusculoskeletal disordersand nausea.How to find a network chiropractic providerAcupuncture (Medicare-covered)You can find network care providers by searching the Acupuncture section of the online provider directoryat the plan website listed on the back of the member’s ID card.Note: If you’re unable to locate a care provider in your area, please contact your local Network AccountManager or Physician Advocate for help. If you don’t know who to contact, go to UHCprovider.com Menu Contact Us.Acupuncture (Routine)You can find a network care provider by searching the acupuncture section of the online provider directoryat the plan website listed on the back of the member’s ID card.Does the member require a referral to receive this service?Acupuncture (Medicare-covered)Members of referral-required plans need a referral for Medicare-covered acupuncture care.Members of open access plans don’t need a referral for Medicare-covered acupuncture care.Acupuncture (Routine)We don’t require referrals for routine acupuncture care.Member cost sharingAcupuncture (Medicare-covered)See the copay listed in the Evidence of Coverage for Medicare-covered acupuncture services.Acupuncture (Routine)See the copay listed in the Evidence of Coverage for routine acupuncture services.continued