Effective Jan. 1, 2026, UHC Medicare Advantage HMO and HMO-POS members require PCP referrals for most specialist services. PCPs must submit referrals prior to visits to avoid claim denials and provider liability.

As an unlisted procedure, reimbursement will be highly variable and not covered by Medicare in an ASC, subject to prior authorization, and at high risk for denial without extensive supporting documentation.

The MILD procedure will transition to new Category I CPT codes: 62330 (first interspace) and 62331 (additional interspaces) effective starting January 1, 2026. Reimbursement has not yet been published.

From compliance to reimbursements, learn why proper coding is the backbone of a healthy revenue cycle.

Simple steps every healthcare provider can take to ensure faster reimbursements and fewer revenue losses.

Discover how AI and automation reduce errors, speed up claims, and improve provider cash flow.