UnitedHealthcare to drop prior authorization for 2,000 pediatric services Dec. 1
UnitedHealthcare said children under 18 on its plans will not need prior authorization for more than 2,000 pediatric care codes starting Dec. 1.
UnitedHealthcare said that beginning Dec. 1, children covered by its plans will no longer need prior authorization for more than 2,000 pediatric care codes, according to the company.
The codes cover services such as ear tube and tonsil procedures, sleep studies, MRI and CT scans, joint and cardiac procedures, and some oncology and chemotherapy services. The company said the change cuts nearly two-thirds of its pediatric prior authorization volume.
Some services will still need prior authorization, including certain injectable medications, genetic tests and surgical procedures, and services that state regulations require the insurer to manage. Some pediatric services will still require advance notification.
The changes apply to UnitedHealthcare commercial plans, Individual Exchange Plans and Community Plans, where state law allows. UnitedHealthcare said it published the full list of codes on Monday so providers can prepare.