Skip to Content

UnitedHealthcare drops certain prior authorizations 

UnitedHealthcare drops certain prior authorizations 

EDINA, Minn. – UnitedHealthcare says it will begin a two-phased approach to eliminating the prior authorization requirement for many procedure codes starting Sept. 1, 2023, to help reduce the administrative burden on health care professionals and their staff. 

This move will reduce the payer’s overall prior authorization volume by nearly 20%. 

“This is part of our comprehensive effort to simplify the health care experience for our members and network health care professionals,” the payer stated. “While prior authorization remains an important tool to address clinical quality and safety, as well as fraud, waste and abuse, we also know that fewer prior authorizations can help streamline care delivery.” 

UnitedHealthcare will eliminate the codes as follows: 

  • On both Sept. 1 and Nov. 1: UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare Individual Exchange plans 

  • Nov. 1 only: UnitedHealthcare Community Plan 

The payer says it will remove some codes across select benefit plans, but there will be differences and health care professionals and their staff should consult each benefit plan. 

In 2024, UnitedHealthcare says it will implement a national Gold Card program for provider groups that meet eligibility requirements. These groups will follow a simple administrative notification process for most procedure codes, rather than the prior authorization process. 


To comment on this post, please log in to your account or set up an account now.