Skip to main content

Medicare Synergy Edits

December 9, 2022

Dear Provider,

Thank you for your continued partnership with Wellcare. As you know, we continually review and update our payment and utilization policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members. We are writing today to inform you of new policies Wellcare will be implementing effective on or after January 9, 2022.

Initiative Name: Medicare Synergy Edits
Lines of Business: Xcelys Medicare
Description: Implementing correct coding edits in accordance with CMS and AMA guidelines to align. Edits cover the following areas: Durable Medical Equipment, Drugs and Biological, Modifiers, Podiatry, Laboratory-Pathology, Evaluation & Management, Incision and Drainage, Frequency, Bundled Facility, and Vitamin D Testing.

For detailed information about these policies, please refer to our website at And for questions about this or any of our payment policies, please don’t hesitate to reach out to our Provider Services team.



Contact Us icon


Y0020_WCM_100876E Last Updated On: 12/9/2022
On April 22, 2024, UnitedHealth Group issued a press release, providing an update on the Change Healthcare cybersecurity incident that occurred on Feb. 21, 2024. Given the size of the data impacted, the investigation to determine whose data is impacted is expected to take several months. UnitedHealth Group believes this situation will impact “a substantial proportion of people in America” and is offering immediate credit monitoring and identity protection services, as well as a dedicated contact center to address questions. Visit Change Healthcare Cyberattack Support and/or reach out to the contact center at 1-866-262-5342 regarding any questions.