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New genetic and molecular codes announced for prior authorization
Act
by Apr 1, 2026
Effective date
Apr 1, 2026
Identified
Jan 12, 2026
Summary
Starting April 1, 2026, UnitedHealthcare will require prior authorization for new genetic and molecular testing code 0605U for commercial and Individual Exchange plans. This adds to existing prior authorization requirements for similar genetic testing codes.
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What to do
by Apr 1, 2026 · 3 steps
01Billing team must update system to require prior authorization for code 0605U genetic and molecular testing.
02Submit prior auth requests through UnitedHealthcare Provider Portal before date of service.
03Claims will be denied and balance billing is prohibited without prior authorization.
Original notice
New genetic and molecular codes announced for prior authorization
uhcprovider.com · Always check the source before changing claims.
Related changes
See all UnitedHealthcare changes →New AMA issued genetic and molecular prior auth requirementsHighEffective Jan 1, 2027 · Network NewsNew genetic and molecular prior auth program requirementsMediumEffective Oct 1, 2026 · Prior authorizationNew genetic and molecular codes announced for prior authorizationMediumEffective Apr 1, 2026 · Network NewsNew genetic and molecular codes required for prior authorizationMediumEffective Jul 1, 2026 · Prior authorizationBrowse every UnitedHealthcare change in the policy list