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New genetic and molecular codes required for prior authorization
Act
by Jul 1, 2026
Effective date
Jul 1, 2026
Identified
Jun 3, 2026
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.
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What to do
by Jul 1, 2026 · 3 steps
01Billing 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.
02Update encounter forms and provider alerts.
03Claims submitted without prior authorization will be denied.
Original notice
New genetic and molecular codes required 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 NewsMedicaid: View new genetic and molecular code updatesMediumEffective Jul 1, 2026 · State newsBrowse every UnitedHealthcare change in the policy list