UnitedHealthcare to cut prior authorization requirements for 1,700 services
UnitedHealthcare is fulfilling its pledge to reduce prior authorization requirements by 30% by the end of the year. Starting October 1, the insurer will no longer require approval for more than 1,700 procedure codes across various plans.
The impacted codes span a broad range of specialties and services, including cardiology and diagnostic imaging, genetic and laboratory testing, outpatient surgery, home health services, and orthopedic and musculoskeletal procedures. UnitedHealthcare provided lists of Current Procedural Terminology (CPT®) codes that will no longer require prior authorization for the following plan types:
UnitedHealthcare was one of the many commercial payers that signed a 2025 pledge to work with CMS to improve their authorization processes. The insurer said this initiative is designed to reduce administrative burden and remove barriers to care, which should give healthcare organizations more time to focus on patients.
UnitedHealthcare also recently enhanced its prior authorization and notification tool, which should prove helpful for organizations as they navigate the changes. Available through the payer’s provider portal, the tool now offers better visibility into authorization requirements, more targeted existing case searches, and other improvements.