July 01, 2024

Michigan: Prior authorization updates for provider administered medications

Beginning Oct. 1, 2024, we will require prior authorization and notification for certain provider administered medications for UnitedHealthcare Community Plan members in Michigan. 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.

View the list of impacted drugs and their HCPCS codes in the table below.

Drug name HCPCS code
Briumvi® J2329
Corticotropin Gel® J0802
Daxxify® J0589
Eylea® HD J0177
Izervay J2782
Leqembi® J0174
Panzyga® J1576
Pombiliti J1203
Qalsody® J1304
Rystiggo® J9333
Syfovre® J2781
Tzield® J9381
Veopoz® J9376
Vyjuvek® J3401
Vyvgart® Hytrulo J9334

How to submit a request

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

  • Go to and click Sign In at the top-right corner
  • Enter your One Healthcare ID and password
  • In the menu, select Prior Authorizations 
  • Scroll down to “Create a new notification or prior authorization request” and select Specialty Pharmacy from the dropdown menu
  • Enter the required information and submit


For contact information, visit our Contact us page. For questions about the prior authorization process, call 888-397-8129.


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