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Developmental Delay and Learning Disabilities
Effective date
Dec 1, 2026
Identified
Nov 7, 2026
Summary
UnitedHealthcare West revised its California Developmental Delay and Learning Disabilities benefit interpretation policy to align with California Health and Safety Code Section 1374.72. Educational services for developmental delays and learning disabilities remain non-covered, and the list of non-covered examples now specifies teaching academic knowledge or skills for grade advancement, special education or instruction designed to improve academic performance, and teaching an individual how to read (reading therapy), including dyslexia-focused educational instruction.
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What to do
Action · 2 steps
01By 2026-12-01: Billing team, update the coverage and service-screening guidance used at scheduling and charge entry so that educational services for developmental delays, learning disabilities, grade-advancement instruction, special education, and reading therapy (including dyslexia-focused instruction) are flagged as non-covered for UnitedHealthcare West California members.
02Tell providers and front desk staff about the revised examples, and confirm with the payer's current policy text which services are included before billing them.
Original notice
Developmental Delay and Learning Disabilities
uhcprovider.com · Always check the source before changing claims.