Genetic and Molecular Prior Authorization Update

Effective July 1, 2020, for UnitedHealthcare commercial members, we will require prior authorization and notification* for additional genetic and molecular testing codes performed in an outpatient setting. We had originally announced that these codes would require prior authorization on March 1, 2020, and then delayed that implementation until June 1, 2020, due to COVID-19.

Updated Codes for Genitourinary Infectious Pathogen:

Effective Sept. 1, 2020, for UnitedHealthcare All Savers members, we will require prior authorization and notification for genetic and molecular testing performed in an outpatient setting.

Visit UHCprovider.com/genetics to learn about the process, see Frequently Asked Questions and review up to date code lists. Also, for more information, you can see the Genetic and Molecular Lab Test tool on Link.

Questions? Call 800-377-8809, Monday through Friday from 7 a.m. to 7 p.m. 

Footnotes:

* Determinations for notification/prior authorization requests will be made based on UnitedHealthcare’s clinical policy requirements for coverage. Our clinical policies can be found at UHCprovider.com/policies.