March 27, 2026
New oncology prior authorization code required
Update
Last modified: April 30, 2026
Table updated to remove 2 codes that will not require prior authorization.
Applies to commercial, Medicare, Medicaid and Individual Exchange plans
To comply with CMS and/or American Medical Association procedure code updates, effective Oct. 1, 2026, prior authorization will be needed for the following HCPCS code when administered in outpatient settings as treatment for cancer diagnosis:
| HCPCS code | Description |
|---|---|
| J2860 | Injection, siltuximab, 10 mg |
This change affects UnitedHealthcare commercial plans and UnitedHealthcare® Medicare Advantage plans in all states, as well as UnitedHealthcare Community Plan and Individual Exchange plans, also referred to as UnitedHealthcare Individual & Family ACA Marketplace plans in the corresponding states:
UnitedHealthcare Community Plan
- Arizona
- Colorado
- Florida
- Hawaii
- Kansas
- Kentucky
- Louisiana
- Maryland
- Mississippi
- Nebraska
- New Jersey
- New Mexico
- New York
- Ohio
- Pennsylvania
- Rhode Island
- Tennessee
- Texas
- Virginia
- Washington
- Wisconsin
UnitedHealthcare Individual Exchange plans
- Alabama
- Arizona
- Colorado
- Louisiana
- Maryland
- Michigan
- Missouri
- Mississippi
- North Carolina
- Nebraska
- Florida
- Georgia
- Indiana
- New Jersey
- New Mexico
- New York
- Ohio
- Oklahoma
- South Carolina
- Tennessee
- Illinois
- Iowa
- Kansas
- Texas
- Virginia
- Washington
- Wisconsin
- Wyoming
Questions? We’re here to help.
- Email unitedoncology@uhc.com
- Visit our Oncology Prior Authorization and Notification page
- Call oncology prior authorization support at 888-397-8129
PCA-1-26-00566-Clinical-NN_03242026
