Effective June 15, 2023, we’ll require prior authorization and update the clinical criteria for sodium-glucose linked transporter 2 (SGLT2) agents. This affects UnitedHealthcare Community Plan of Texas STAR, STAR kids and STAR+Plus plans, and is based on new Texas Health and Human Services Prior Authorization Program Clinical Criteria.
|Medications||Clinical criteria||ICD code changes|
|Farxiga®, Invokana®, Jardiance® and Steglatro®||SGLT2 inhibitor single-entity agents||
ICD-9 codes we’re removing
New ICD-10 code we’re adding
|Invokamet®, Segluromet®, Synjardy® and Xigduo® XR||SGLT2 inhibitor combination agents|
You can submit a prior authorization request through the UnitedHealthcare Provider Portal:
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.
Please contact your physician advocate or call Provider Services at 888-887-9003.