In late 2025, UnitedHealthcare announced it will continue some expanded telehealth benefits under its Medicare Advantage (MA) plans through 2026, a notable divergence from the more restrictive telehealth rules recently reinstated for Original Medicare.

This development matters not only for patients, but also for credentialing and billing teams who must stay aligned with evolving payer coverage and reimbursement policies.

Here’s a clear breakdown of what’s changing, why it matters, and how providers should prepare.

What UnitedHealthcare’s Update Means

UnitedHealthcare’s announcement confirms that under many of its MA plans:

• In‑home telehealth services will continue to be covered
• Medical, mental health, and clinician telehealth visits will remain reimbursable
• Both audio‑only and video telehealth modalities may be permitted when eligible services are included on the Medicare list
  The continued benefit applies specifically within UnitedHealthcare MA plans and does not modify telehealth coverage for Original Medicare.

This decision reflects flexibility that MA plans have to determine their own coverage standards — even as the Centers for Medicare & Medicaid Services (CMS) tightens or phases out some pandemic‑era telehealth waivers for traditional Medicare.

Why This Matters for Credentialing and Billing

1. Provider Enrollment and Network Participation

MA plans typically require providers to be properly credentialed and contracted to bill telehealth services at network rates. Credentialing teams should verify that telehealth services are included in provider agreements for each plan variation.

Failing to confirm coverage details may lead to:

• • Claims denials when services are outside the defined scope
  • Improper billing if coding guidelines are misunderstood

2. Coding, Documentation, and Reimbursement Risk

Telehealth visits are often billed using specific codes and modifiers. Miscommunication between payer policy updates and practice billing can easily lead to:

• • Denials due to outdated coding workflows
  • Claims rejected for lack of documented telehealth eligibility
    Billing teams should update internal claims rules and train staff on the latest UnitedHealthcare MA telehealth coding expectations to avoid payment delays.

3. Patient Scheduling and Cost Transparency

The extension of telehealth benefits also affects patient scheduling and communication. Practices must:

• • Check telehealth eligibility before appointments
  • Inform patients about potential copays or coverage differences
  • Coordinate with billing to confirm member benefits before telehealth delivery

What Has Changed in Medicare Telehealth Rules

Under Original Medicare, many pandemic‑era telehealth flexibilities expired in late 2025 unless renewed by Congress or incorporated into ongoing Medicare policy. While some federal extensions were passed into law temporarily, the framework of telehealth coverage continues to evolve.

Medicare Advantage plans operate under a different set of authorities. MA plans can choose to maintain, expand, or reduce coverage compared with Original Medicare, which is why UnitedHealthcare’s 2026 telehealth decision is particularly important.

For credentialing and billing operations, this means pay attention to payer‑specific policies, not just national Medicare rules.

Action Steps for Practices

Here’s how providers and billing teams can prepare and adapt:

1. Review UnitedHealthcare MA Telehealth Policies

• • Access the latest plan documents or provider bulletins
  • Confirm telehealth service eligibility by plan type
  • Align internal claim edits with plan requirements

2. Verify Credentialing and Billing Readiness

• • Confirm that clinicians are credentialed for MA telehealth services
  • Verify that telehealth services are included in payer contracts
  • Document telehealth eligibility in practice management and billing systems

3. Update Coding and Claims Workflows

Telehealth billing often requires:

• • Place of service (POS) codes
  • Modifier usage (such as telehealth modifiers when applicable)
  • Provider and facility identifiers
  • Training billing staff on updated telehealth rules will reduce denials and improve cash flow.

4. Educate Clinical Teams

Clinical teams often aren’t aware of payer‑specific telehealth rules. Education ensures:

• • Proper documentation
  • Clear patient communication
  • Compliance with telehealth requirements across plans

Why This Matters Beyond 2026

The extension of telehealth benefits in MA plans is more than a short‑term adaptation, it reflects a longer trend:

Telehealth is becoming an established part of patient care delivery, especially in behavioral health, chronic disease management, and follow‑ups.

At the same time, payer policies continue to diverge, meaning credentialing, billing, and contracts must stay synchronized with evolving coverage rules.

Konnext Solutions: Helping Providers Stay Current

Keeping up with payer policy evolution, especially in a complex area like Medicare Advantage telehealth — is challenging.

At Konnext Solutions, we help practices:

• Review payer policies and coverage changes
• Update credentialing and billing configurations
• Train staff on telehealth documentation and billing
• Monitor payer communication for policy shifts

Whether you are preparing for telehealth billing or managing complex MA contracts, proactive alignment safeguards revenue and compliance.

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