UnitedHealthcareMedium ImpactPrior Auth
New genetic and molecular codes required for prior authorization
Published June 3, 2026Effective July 1, 2026
AI Summary
UnitedHealthcare is adding 10 new genetic and molecular testing procedure codes (0616U-0628U) to their prior authorization requirements, effective July 1, 2026. This affects specific commercial and Individual Exchange plans across all states.
Action Required
By July 1, 2026: Billing team must update systems to require prior authorization for genetic/molecular testing codes 0616U, 0618U, 0619U, 0622U, 0623U, 0624U, 0625U, 0626U, 0627U, and 0628U for UnitedHealthcare commercial and Individual Exchange plans. Update encounter forms and provider alerts. Claims submitted without prior authorization will be denied.
Plan Types
Commercial, Exchange
Specialties
laboratory, oncology, endocrinology, neurology, cardiology