Prior Authorization - UnitedHealthcare

UnitedHealthcare is cutting 20 percent of its prior authorizations in two waves. The first cuts take effect Sept. 1 and the second phase goes into effect Nov. 1.

Here are the cuts UnitedHealthcare is making to its individual exchange plan prior authorization requirements, broken down by category. See the individual codes being eliminated here: https://www.uhcprovider.com/content/dam/provider/docs/public/resources/news/2023/codes/PP-prior-auth-reductions-Exchange.pdf

Effective Sept. 1

Arthroplasty: 2

Breast reconstruction (non-mastectomy): 1

Durable medical equipment: 4

Hysterectomy: 2

Orthopedics/prosthetics: 2

Genetic testing: 208

Spine surgery: 4

Site of service: 99

Effective Nov. 1

Unlisted: 4

Radiology: 66