Search

UnitedHealthcare Commercial 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 Commercial plans are listed below.

Expand All add_circle_outline

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.

Copies of UnitedHealthcare's Medical Policies, Medical Benefit Drug Policies, CDGs, URGs, and QOCGs can also be obtained by sending a written request to:

UnitedHealthcare Policy Requests
4 Research Drive
Shelton, CT 06484

For questions, please contact your local Network Management representative or call the Provider Services number on the back of the member’s ID card.

To submit new or additional clinical evidence pertaining to a specific medical policy, click here to complete a form for UnitedHealthcare Medical Policy review. Do not submit protected health information using this form. If you have questions or concerns about a specific service for a member, refer to the appropriate Benefits, Claims, or Prior Authorization/Notification process.