May 01, 2022

Minnesota Medicaid: New prior authorization requirement for cognitive rehabilitation

Effective June 1, 2022, prior authorization will be required for cognitive rehabilitation services (procedure code H2012 HK) for UnitedHealthcare Community Plan members enrolled in Families & Children and MNCare plans.

This requirement applies to members whose ID cards list the group number MNHCP.

How do I request prior authorization?
Use the Prior Authorization and Notification tool on the UnitedHealthcare Provider Portal to submit your request for dates of service on or after June 1, 2022. You’ll need to include all relevant clinical information, which will be subject to a medical necessity review.

Here’s how to submit your request:

  • Go to UHCprovider.com and select Sign In in the upper-right corner
  • Sign in to the portal with your One Healthcare ID and password. If you don’t have a One Healthcare ID, visit UHCprovider.com/access to get started.

Medical necessity reviews are conducted by licensed medical professionals. We’ll notify you and your patient of the review results.

Will these requirements affect claims? 
Yes. If you don’t obtain a prior authorization online before performing the service, your claim for that service will be denied. If this happens, the patient cannot be billed for the service.

Learn more
Review the medical necessity guidelines used to help facilitate the medical necessity determinations for cognitive rehabilitation services. We align with Minnesota Department of Human Services prior authorization requirements.  

Questions?
Call the Provider Services Call Center at 877-440-9946, 8 a.m.–5 p.m. CT, Monday–Friday.

PCA-22-01205-C&S-News