Updated prior authorization requirement for genetic and molecular codes
Newly issued AMA codes have been added to genetic and molecular prior authorization/advance notification program requirements
Effective Jan. 1, 2024, we’ll require prior authorization or advance notification for newly issued genetic and molecular procedure codes. As new procedure codes are issued, it is standard practice for these codes to be added to existing prior authorization and advanced notification requirements.
This affects select UnitedHealthcare commercial plans and all UnitedHealthcare Individual Exchange plans, also referred to as UnitedHealthcare Individual & Family ACA Marketplace plans, as follows:
UnitedHealthcare of the Mid-Atlantic, Inc.
UnitedHealthcare Plan of the River Valley, Inc.
UnitedHealthcare Insurance Company of the River Valley
Oxford Health Insurance, Inc.
All Savers Insurance Company
All Savers Life Insurance Company of California
UnitedHealthcare Individual Exchange plans
Neighborhood Health Partnership, Inc.
In addition to the current in-scope procedure codes, we’re adding the following codes to the existing prior authorization/advance notification requirements:
How to submit a request
You can submit a prior authorization request through the UnitedHealthcare Provider Portal:
Chat with a live advocate 7 a.m.–7 p.m. CT from the UnitedHealthcare Provider Portal. You can also contact UnitedHealthcare Provider Services at 877-842-3210, TTY/RTT 711, 7 a.m.–5 p.m. CT, Monday–Friday.