UnitedHealthcareMedium ImpactPrior Auth
New genetic and molecular codes announced for prior authorization
Published January 12, 2026Effective April 1, 2026
AI 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.
Action Required
By April 1, 2026: Billing team must update system to require prior authorization for code 0605U genetic and molecular testing. Submit prior auth requests through UnitedHealthcare Provider Portal before date of service. Claims will be denied and balance billing is prohibited without prior authorization.
Plan Types
Commercial, Exchange
Specialties
laboratory, oncology, pathology