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Hereditary cancer testing policy reminder

Act
immediately
Effective date
Not stated in the notice
Identified
Sep 2, 2026

Summary

UnitedHealthcare is reminding providers that multigene RNA panel testing for hereditary cancer is considered unproven and will be denied. Only DNA-only hereditary cancer panels and single-gene RNA testing remain covered under applicable medical policy and prior authorization requirements.

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What to do

immediately · 3 steps
01Billing team must update claim submission guidelines to flag and deny multigene RNA panel hereditary cancer tests across all affected UnitedHealthcare plans.
02Implement system logic to differentiate between covered DNA-only panels and non-covered multigene RNA panels.
03Update provider encounter forms and templates to indicate that multigene RNA hereditary cancer panels require denial with reason code 'unproven service.' Train billing staff and providers that hereditary cancer panels performed simultaneously with multigene RNA analysis will be denied.
If missed: Failure to apply this policy will result in claims being processed for non-covered services, requiring subsequent denial and potential recovery efforts.

Original notice

Hereditary cancer testing policy reminder
uhcprovider.com · Always check the source before changing claims.
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