Medicaid: New prior authorization codes in select states

Effective Sept. 1, 2021, we are adding new codes to the prior authorization list for UnitedHealthcare Community Plans (Medicaid, Long-Term Care) in Florida, Mississippi, New Jersey, Pennsylvania and Tennessee.

UnitedHealthcare Community Plans

  • Florida
    • Cosmetic and reconstructive
    • Durable medical equipment
    • Hysterectomy
    • Vein procedures
  • Mississippi
    • Cosmetic and reconstructive
    • Durable medical equipment
    • Hysterectomy
    • Vein procedures
  • New Jersey
    • Cosmetic and reconstructive
    • Durable medical equipment
    • Hysterectomy (includes criteria change to existing prior authorization codes)
    • Vein procedures
  • Pennsylvania
    • Cosmetic and reconstructive
    • Durable medical equipment
    • Hysterectomy (includes criteria change to existing prior authorization codes)
    • Vein procedures
  • Tennessee
    • Cosmetic and reconstructive
    • Durable medical equipment
    • Sterilization
    • Vein procedures

Effective July 1, 2021, additional codes will be added to the prior authorization list for UnitedHealthcare Community Plans (Medicaid) in Hawaii and Ohio. (These codes are additions to our announcement in the April Network Bulletin.)

  • Hawaii: Cosmetic and reconstructive CPT® code 14041
  • Ohio: Cosmetic and reconstructive CPT code 14061

Questions?

PCA-1-21-01387