UnitedHealthcareMedium ImpactPrior Auth
New genetic and molecular codes announced for prior authorization
Published June 3, 2026Effective April 1, 2026
AI Summary
UnitedHealthcare will require prior authorization for new genetic and molecular testing code 0605U starting April 1, 2026. This affects commercial and Individual Exchange plans nationwide and aligns with existing prior authorization requirements for genetic testing.
Action Required
Before April 1, 2026: Billing team must update system to require prior authorization for code 0605U genetic and molecular testing. Update encounter forms and EMR templates to alert providers. Submit prior authorization requests through UnitedHealthcare Provider Portal before date of service. Claims will be denied without prior authorization and providers cannot balance bill members.
Plan Types
Commercial, Exchange
Specialties
laboratory, oncology, pathology, family-medicine, internal-medicine