CurrentColorado Rocky Mountain Health PlansPolicy 2026R8219A

Vitamin B12 and Homocysteine testing reimbursement

Defines UnitedHealthcare Medicare Advantage reimbursement methodology and frequency limits for Vitamin B12 (total) and homocysteine testing billed on UB04 or CMS 1500 forms for Medicare Advantage enrollees and providers.

Policy Summary

PayerColorado Rocky Mountain Health Plans

PolicyVitamin B12 and Homocysteine testing reimbursement

Policy CodePolicy 2026R8219A

Change TypeNo material change

Effective Date

Next Review Date

Key ActionLimit total Vitamin B12 (82607) reimbursement to one unit every 90 calendar days and consider homocysteine (83090) for reimbursement when diagnosis is Vitamin B12 deficiency.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

82607Total Vitamin B12 code

83090Homocysteine code

1/90dB12 frequency limit

Condition-basedHomocysteine coverage

Reimbursement Criteria for Vitamin B12 and Homocysteine Testing

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Vitamin B12 and Homocysteine testing criteria

Covered when the following reimbursement limits and condition-based criteria are met:

Policy applies to services billed on UB04 and CMS 1500 forms for UnitedHealthcare Medicare Advantage members (see Application).

Total Vitamin B12 testing (CPT 82607) reimbursed up to once every three months (one unit every 90 calendar days).

Frequency limit enforced across all providers and facilities for each member.

Homocysteine testing (CPT 83090) considered for reimbursement WHEN the member has a diagnosis of Vitamin B12 deficiency.

Procedure Codes, Frequency Limits, and Coding Details

Total Vitamin B12 testingCPTCovered

82607

Total Vitamin B12

Homocysteine testingCPT

83090

Homocysteine

Total Vitamin B12 frequency limit

LimitOne unit every 90 calendar days (up to once every three months)

Applies toTotal Vitamin B12 testing procedure codes (see coding section)

EnforcementFrequency limit applies regardless of billing or rendering provider for each member

Provider Requirements and Enforcement Notes

Note

Prior authorization note

No prior authorization information is provided in this policy. Providers should verify any prior authorization requirements through the member’s benefit documents or by contacting the plan before delivering services.

Check the member’s ID card and benefit documents for prior authorization requirements.
Contact Colorado Rocky Mountain Health Plans provider services if prior authorization status is unclear.

Denial Risk

Frequency enforcement

Frequency limits apply across all providers and facilities for each member — limits are enforced per member regardless of which provider or facility bills for the service.

Frequency limitations are not tied to the individual billing or rendering provider.
The limit applies to any provider or facility submitting claims for the same member.
Ensure scheduling and documentation reflect that prior services from other providers/facilities count toward the member’s frequency limit.