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UnitedHealthcareMedicaid · Prior Auth · State news · FL, HI, KS, KY, MD, MI, MO, NE, NJ, NM, NY, PA, RI, TN, TX, VA, WA, WI · Oncology, OB-GYN, Cardiology +1 moreMedium impact

Medicaid: View new genetic and molecular code updates

Act
by Jul 1, 2026
Effective date
Jul 1, 2026
Identified
Jun 3, 2026

Summary

UnitedHealthcare is updating prior authorization and advance notification requirements for genetic and molecular procedure codes effective July 1, 2026, to comply with American Medical Association code changes. This affects multiple UnitedHealthcare Community Plans across 18 states.

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What to do

by Jul 1, 2026 · 3 steps
01Billing team must review the state-specific genetic and molecular code lists to identify which codes will require new prior authorization or advance notification.
02Update billing system workflows to require prior auth for affected genetic testing codes.
03Train staff on submitting prior authorizations through the UnitedHealthcare Provider Portal using One Healthcare ID.

Original notice

Medicaid: View new genetic and molecular code updates
uhcprovider.com · Always check the source before changing claims.
View original ↗

Related changes

See all UnitedHealthcare changes →
New 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 authorizationNew genetic and molecular codes announced for prior authorizationMediumEffective Apr 1, 2026 · Prior authorization updatesBrowse every UnitedHealthcare change in the policy list

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