July 01, 2023

Ohio Medicaid: Radiofrequency ultrasound guidance procedure updates

Coverage expansion and prior authorization requirements for Ohio Medicaid members

Starting Aug. 1, 2023, we’re expanding our coverage of radiofrequency ultrasound guidance procedures. To ensure patients receive coverage for quality care according to the most up-to-date clinical guidelines, we’ll require prior authorization for procedure codes 58674 and 0404T. The codes will be added to our Abnormal Uterine Bleeding and Uterine Fibroids Medical Policies.

Affected plan

This affects the UnitedHealthcare Community Plan of Ohio.

How to submit a request

You can submit a prior authorization request through the UnitedHealthcare Provider Portal:

  • Go to and select Sign In at the top-right corner
  • Sign in to the portal using your One Healthcare ID and password
  • In the menu, select Prior Authorizations
  • In the Prior Authorization and Notification tool, scroll down to “Create a new notification or prior authorization request” and click Create New Submissions
  • Enter the required information and submit

If we don’t receive a prior authorization request before the date of service, we’ll deny the claim and you won’t be able to balance bill members.


See our updated Abnormal Uterine Bleeding and Uterine Fibroids medical policies at Policies and Protocols for Healthcare Providers.


If you have questions, please visit our Prior Authorization and Notification page.

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