Nov Industry Notes: UHC – New GA Modifier Requirements 

Beginning Feb. 1, 2025, UHC is adding the following GA modifier requirement for their commercial plans. If you know or have reason to suspect that a commercial member’s benefits do not cover the service, a GA modifier must be submitted on the claim in order to bill for the non-covered service. The GA modifier will be used to document when the enhanced content requirements of the consent are met.  

The aim of requiring use of the GA modifier is to improve health care transparency by helping ensure members were made aware of their potential liability in advance of any procedure or bill they may receive for services.  

Including the GA modifier on your claim for the non-covered service helps ensure it is adjudicated as member liability where appropriate. 

Review this new procedure at https://www.uhcprovider.com/content/dam/provider/docs/public/admin-guides/2024-UHC-Administrative-Guide.pdf#page=151.