Pediatric Patients Exempt From UHC Imaging Program

Advocacy by the American College of Radiology® (ACR®) and American Academy of Pediatrics (AAP) for more than a year resulted in UnitedHealthcare (UHC) updating its Designated Diagnostic Provider program for advanced diagnostic imaging services to exclude all pediatric patients. The exemption took effect May 1.

The program, started by UHC in select states in 2022, offers reduced cost sharing benefits to patients who choose “Designated Diagnostic Providers” (DDPs) for advanced diagnostic imaging services. In-network providers may become DDPs by completing a quality questionnaire and meeting efficiency standards as defined by the insurer. Patients who utilize non-DDP imaging centers incur greater cost.

The program initially exempted only pediatric patients under age seven. ACR and AAP met with UHC several times to discuss the unique nature of pediatric imaging for patients under age 18 that makes it extremely difficult for pediatric-focused imaging facilities to become DDPs.

UHC executives verbally acknowledged during a November meeting that the quality and efficiency standards developed for the program were most suited to adults and suggested exempting all pediatric patients. Numerous follow-up discussions and e-mails occurred in late 2024 and 2025 to ensure that pediatric patients would continue to have lowest cost access to pediatric imaging specialists with this exemption.

ACR and AAP continue to work with UHC to communicate the updated policy to physicians and patients.

For questions about the UnitedHealthcare DDP program, contact Katie Keysor, ACR Senior Director, Economics and Health Policy.