Vitamin B12 Testing Reimbursement Policy
Customize your policy alerts
Sign up for Colorado Rocky Mountain Health Plans Policy 2026R8114A alerts
Get alerted when Policy 2026R8114A changes without checking for updates manually.
Monitor payer policy activity
Reimbursement policy governing payment and frequency limits for Vitamin B12 and related homocysteine laboratory testing for UnitedHealthcare Community Plan Medicaid products and providers billing on CMS-1500 or UB-04 forms.
No material clinical or coverage changes in this revision.
Coverage Criteria
Coding and Codes
| 82607 | Total Vitamin B12; measured directly (procedure code listed for total Vitamin B12 testing) |
| 83090 | Homocysteine; procedure code listed for homocysteine testing |
Covered Indications
Vitamin B12 deficiency — Homocysteine testing (83090) reimbursed for vitamin B12 deficiency per policy.
Homocysteine testing is covered when performed for the specified clinical indication:
Frequency Limits
Provider Actions and Billing
Billing forms and applicability
This reimbursement policy applies to services reported using the UB-04 Form, the 1500 Health Insurance Claim Form (CMS-1500) or their electronic equivalents for UnitedHealthcare Community Plan Medicaid products.
- Applies to UnitedHealthcare Community Plan Medicaid products.
- Acceptable claim forms: UB-04, CMS-1500 (1500 Health Insurance Claim Form) or electronic equivalents.
Ordering Requirements
Ordering provider applicability
The policy applies to all products and to all network and non-network providers; no specific ordering-provider restrictions are stated.
- Includes network and non-network providers, such as hospitals, ambulatory surgical centers, physicians, and other qualified health care professionals.
- Also applies to non-network authorized and percent-of-charge contract providers.
Definitions
Not Covered / Exemptions
The policy identifies multiple state exceptions where this reimbursement policy does not apply. Specifically, the policy lists the following jurisdictions as exempt from the policy: Arizona, Colorado, Florida, Hawaii, Idaho, Indiana, Kansas, Kentucky, Maryland, Massachusetts, Missouri, Nebraska, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia, Washington DC, Washington, and Wisconsin. For services rendered in these states or jurisdictions, the provisions of this policy are not applicable.
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.