MedicaidPrior AuthMedium impact
Medicaid: Prior authorization removal for select electrical stimulation codes
UnitedHealthcare·AZ, CO, FL, IN, NJ, NM, TX · Physical Therapy, Pain Management, Orthopedics +1 more·State news
Effective date
Sep 1, 2026
We identified it
Jul 2, 2026
Summary
Effective September 1, 2026, UnitedHealthcare Community Plans will remove prior authorization requirements for electrical stimulation codes G0281 and G0282 in seven states. Billing teams must update their systems to stop requiring prior authorization for these codes to avoid unnecessary delays and claim processing issues.
Action Required
By August 31, 2026: Billing team must update billing software to REMOVE prior authorization requirements for CPT codes G0281 and G0282 for UnitedHealthcare Community Plans in Arizona, Colorado, Florida, Indiana, New Jersey, New Mexico, and Texas. Remove prior auth flags from claims processing rules, encounter forms, and verification workflows for these codes in affected states. Update provider communication materials to reflect the change. After September 1, 2026, do not request prior authorization for G0281 and G0282 in these states, as removal of the requirement will streamline claims submission and reduce processing delays.