December 05, 2019

UnitedHealthcare Summarizes Prior Authorization Changes for 2019-2020

The UnitedHealthcare Provider Network Bulletin for December includes an article summarizing all prior authorization policy changes announced in 2019, including some changes that will be effective in early 2020.

Specific to radiology, effective March 1, 2020, CPT® code 76391 (Magnetic resonance (eg, vibration) elastography) will be subject to prior authorization for UHC commercial plans. In addition, UnitedHealthcare Oxford plans will implement site of service prior authorization for MR and CT services effective February 1, 2020.

UHC also added many non-radiology codes to site of service medical necessity reviews effective in February and March 2020. Impacted specialties include cardiology, general surgery, dermatology, podiatry, gynecology, urology and gastroenterology. Alaska, Kentucky, Massachusetts, Texas, Utah and Wisconsin are excluded from these prior authorization policies.