CAP offers update on UHC DDP program

March 25, 2021

Although United Healthcare’s Designated Diagnostic Provider Program (DDP) is set to launch July 1, many labs who will be affected by the move to restrict outpatient lab payments for diagnostic services to a select group of in-network providers are still seeking clarification on a number of issues.

Fortunately, the College of American Pathologists (CAP) has been in regular contact with UHC and provided and update on details of the program’s rollout following a March 22 meeting with UHC reps, according to the latest CAP Advocacy Update.

As previously reported, there is no deadline for providers to complete the survey to be considered for inclusion. However, CAP did confirm the program applies to any provider billing laboratory services using POS 19, 22, or 81, and includes the entire lab and pathology suite of CPT codes.

Additionally, while there is no deadline to complete the survey, UHC reps did recommend that interested providers should fill it out sooner rather than later. Those who complete it by May 15 will be included in current beneficiary plan materials/education.

Finally, UHC said it is adjusting the survey to make it easier for all pathology groups to apply. They also clarified that the questionnaire should be completed at the TIN level, as opposed to individual providers applying via NPI.

CAP’s full summary may be viewed here.

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