Starting July 1, 2021, preimplantation genetic testing (PGT) will be covered as a standard benefit for eligible UnitedHealthcare commercial plan members when they or their partners are carriers for a specific genetic disorder.
You’ll need to complete the prior authorization process and supply specific medical documentation when requesting PGT for the following CPT® codes:
The following documentation must be included with your prior authorization request:
PGT is a genetic test that can be performed on an embryo during the assisted reproductive process. A sample of the embryo is sent to the laboratory to look for changes in genes and/or chromosomes.
PGT tests are performed prior to pregnancy and in vitro fertilization (IVF). This is a necessary step to allow for the testing.
Our program focuses on the types of PGT that can diagnose specific inherited conditions caused by a single-gene (PGT-M) or structural changes of a parent’s chromosome (PGT-SR) that could result in a significant health problem or severe disability.
This new benefit will be available after July 1, 2021, for members who are on a new plan or upon renewal of their existing plans after this date.
Learn how to check requirements, submit new authorizations / notifications, check status, and submit updates by registering for live event or using the Prior Authorization and Notification Interactive User Guide.