UnitedHealthcare Reduces Prior Authorization Requirements for 1,700 Medical Codes, Limited Impact on Medicare Advantage
UnitedHealthcare announced it will eliminate prior authorization requirements for approximately 1,700 Current Procedural Terminology (CPT) codes, effective October 1. This change applies across its commercial, Medicare Advantage, Medicaid, and Affordable Care Act (ACA) plans, representing about 30% of its total preapproval requirements. However, the impact on Medicare Advantage and dual special needs plans (D-SNPs) is significantly smaller, with only about 120 of these codes applying to these specific plans. The Center for Medicare Advocacy further refined this, noting that roughly 70 codes are relevant to general Medicare Advantage and D-SNP members, with additional codes exclusively for D-SNPs. This initiative follows a pledge made earlier in the year to reduce prior authorizations by 30% by the end of 2026. The codes span various medical fields, including oncology, cardiology, orthopedics, genetic testing, chiropractic care, and home health services. UnitedHealthcare stated that the focus was on service...