As of June 1, 2023, prior authorizations for gastroenterology endoscopy services are required for UnitedHealthcare commercial plan members. Please note screening colonoscopy procedures are not included in this new medical necessity review requirement.
This requirement pertains to patients with UnitedHealthcare commercial plans, including:
Currently, some gastroenterology endoscopy procedures may require prior authorization and site of service medical necessity review if the procedure is planned in an outpatient hospital. Beginning June 1, 2023, we’ll require prior authorization for these procedures regardless of the outpatient location in which you plan to perform the procedure.
Screening colonoscopy procedures only require prior authorization for site of service medical necessity review if the service is planned at an outpatient hospital.