Community Plan Medical & Drug Policies and Coverage Determination Guidelines

The Medical Policies, Medical Benefit Drug Policies, Coverage Determination Guidelines, Utilization Review Guidelines and corresponding update bulletins for UnitedHealthcare Community Plan are listed below.

Click the "+" sign to view more information.

A monthly notice of recently approved and/or revised Medical Policies, Medical Benefit Drug Policies, Coverage Determination Guidelines (CDGs), and Utilization Review Guidelines (URGs) is provided below for your review. We publish a new announcement on the first calendar day of every month.

The appearance of a health service (e.g., test, drug, device or procedure) in the Medical Policy Update Bulletin does not imply that UnitedHealthcare provides coverage for the health service. In the event of an inconsistency or conflict between the information provided in the Medical Policy Update Bulletin and the posted policy, the provisions of the posted policy will prevail.

For Kentucky, click here to view the Medical Policy Update Bulletins.

 

Current Policies & Guidelines

For Kentucky, click here to view the Medical & Drug Policies and Coverage Determination Guidelines.

For Louisiana, click here to view MCG criteria for the top Outpatient procedures and Admission diagnoses.