CommercialCoverageMedium impact
Cosmetic and Reconstructive Procedures
UnitedHealthcare·Plastic Surgery, General Surgery, Orthopedics +4 more·Medical Policy
Effective date
Jun 1, 2026
We identified it
Jun 2, 2026
Summary
UHC updated their cosmetic and reconstructive procedures policy effective June 1, 2026. This policy change affects coverage determinations and billing requirements for procedures that may be considered cosmetic versus medically necessary reconstructive surgery.
Action Required
By June 1, 2026: Billing team must review and update prior authorization requirements for cosmetic and reconstructive procedures. Providers should ensure proper documentation of medical necessity for reconstructive procedures to distinguish from cosmetic services. Update encounter forms and billing system edits to reflect new coverage criteria. Claims for cosmetic procedures may be denied without proper medical necessity documentation.