In their July 2025 Reimbursement Policy Update, United Healthcare (UHC) announced that they will implement a 15% reduction in reimbursement on Anesthesia Professional claims submitted for services rendered by a Certified Registered Nurse Anesthetist (CRNA) for personally performed anesthesia services when appended with the QZ modifier. This update is scheduled to begin October 1, 2025.
This change applies to UHC Commercial Plans and Exchange Plans. Providers performing services in Arkansas, California, Colorado, Hawaii, Massachusetts, New Hampshire, and Wyoming will be excluded from this reduction.
UHC notes that this change more precisely aligns the reimbursement methodology for CRNAs with other advanced practice providers.
UHC plans to align with CMS regarding the modifying units portion of the anesthesia calculation to no longer include the units for physical status modifiers P3, P4 and P5 in the anesthesia reimbursement calculation, as well as to no longer include additional units for qualifying circumstances codes 99100, 99116, 99135 and 99140 in the anesthesia reimbursement calculation.
Ventra Health will continue to append the appropriate modifiers based on the services rendered for the coding and billing of the UHC Commercial and Exchange plan claims.
UHC’s full policy update can be found here: 7/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: July 2025
