UnitedHealthcare policies

Search UnitedHealthcare's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

453 public policies Substrate tracks for UnitedHealthcare, by title.

UnitedHealthcare policies
PolicyDetailsCodesSource
[Prior Authorization] UnitedHealthcare Community Plan Michigan Medicaid Prior Authorization Requirements - April 2026Effective Apr 1, 2026 · Medicaid1,232Original policy ↗
[Reimbursement] 1/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: January 2025Commercial11Original policy ↗
[Reimbursement] 1/1/2026 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: January 2026Commercial4Original policy ↗
[Reimbursement] 10/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: October 2025Commercial—Original policy ↗
[Reimbursement] 11/1/2024 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: November 2024Commercial21Original policy ↗
[Reimbursement] 11/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: November 2025Commercial3Original policy ↗
[Reimbursement] 12/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: December 2025Commercial4Original policy ↗
[Reimbursement] 2/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: February 2025Commercial17Original policy ↗
[Reimbursement] 3/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: March 2025Commercial17Original policy ↗
[Reimbursement] 4/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: April 2025Commercial14Original policy ↗
[Reimbursement] 5/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: May 2025Commercial—Original policy ↗
[Reimbursement] 6/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: June 2025Commercial1Original policy ↗
[Reimbursement] 7/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: July 2025Commercial5Original policy ↗
[Reimbursement] 8/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: August 2025Commercial5Original policy ↗
[Reimbursement] 9/1/2025 – UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: September 2025Commercial5Original policy ↗
[Reimbursement] B Bundle Codes Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans and Individual ExchangeCommercial47Original policy ↗
[Reimbursement] CCI Editing Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans and Individual Exchange2025R0105A · Commercial10Original policy ↗
[Reimbursement] Discarded Drugs and Biologicals Policy, Professional and Facility Policy - Reimbursement Policy - UnitedHealthcare Commercial and Individual Exchange2026R6004A · Commercial—Original policy ↗
[Reimbursement] Discontinued Procedure Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial and Individual Exchange2026R0110A · Commercial—Original policy ↗
[Reimbursement] Inpatient Readmission Review Policy, Facility - Reimbursement Policy - UnitedHealthcare Commercial and Individual Exchange2026R5023A · Commercial—Original policy ↗
[Reimbursement] Microsurgery Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial and Individual ExchangeCommercial221Original policy ↗
[Reimbursement] Modifier Reduction Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans and Individual ExchangeCommercial—Original policy ↗
[Reimbursement] Modifier Reference Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans and Individual ExchangeCommercial2Original policy ↗
[Reimbursement] Multiple Procedure Payment Reduction (MPPR) for Diagnostic Imaging Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial and Individual ExchangeCommercial4Original policy ↗
[Reimbursement] Observation and Discharge Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial and Individual ExchangeCommercial10Original policy ↗
[Reimbursement] Off-Campus Provider-Based Departments Billed with Modifier PO Policy, Facility - Reimbursement Policy - UnitedHealthcare Commercial and Individual ExchangeCommercial1Original policy ↗
[Reimbursement] Once in a Lifetime Procedures Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial and Individual Exchange2026R0116A · Commercial4Original policy ↗
[Reimbursement] Outpatient Hospital Blood and Blood Products Policy Facility - Reimbursement Policy - UnitedHealthcare Commercial Plans and Individual ExchangeCommercial27Original policy ↗
[Reimbursement] Outpatient Hospital CCI Editing Policy, Facility - Reimbursement Policy - UnitedHealthcare Commercial Plans and Individual ExchangeCommercial6Original policy ↗
[Reimbursement] Physical Medicine & Rehabilitation: Multiple Therapy Procedure Reduction Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial and Individual Exchange2026R0121A · Commercial—Original policy ↗
[Reimbursement] Physical Medicine & Rehabilitation: Speech Therapy Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans and Individual ExchangeCommercial—Original policy ↗
[Reimbursement] Prolonged Services Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial and Individual ExchangeCommercial23Original policy ↗
[Reimbursement] Radiation Therapy Planning, Dosimetry, Simulation/Devices and Management Policy, Professional and Facility - Reimbursement Policy - UnitedHealthcare Commercial and Individual Exchange2026R5038A · Commercial16Original policy ↗
[Reimbursement] Rebundling Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans and Individual ExchangeCommercial21Original policy ↗
[Reimbursement] Robotic Assisted Surgery Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial and Individual Exchange2025R0114A · Commercial1Original policy ↗
[Reimbursement] Telehealth Policy, Facility - Reimbursement Policy - UnitedHealthcare Commercial and Individual ExchangeCommercial1Original policy ↗
[Reimbursement] Telehealth/Virtual Health Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans and Individual ExchangeCommercial6Original policy ↗
[Reimbursement] Vitamin D Testing Policy, Professional and Facility - Reimbursement Policy - UnitedHealthcare Commercial and Individual ExchangeCommercial3Original policy ↗
Ablative Treatment for Spinal Pain2026T0107II · Effective Feb 1, 2026 · Commercial6Original policy ↗
Abnormal Uterine Bleeding and Uterine Fibroids2026T0442VV · Effective Jan 1, 2026 · Commercial10Original policy ↗
Acupuncture Policy, ProfessionalCommercial10Original policy ↗
Adakveo® (Crizanlizumab-Tmca)2026D0085L · Effective May 1, 2026 · Commercial1Original policy ↗
Add-on Codes Policy, ProfessionalCommercial17Original policy ↗
Advanced Practice Health Care Provider Policy, ProfessionalEffective Jan 29, 2025 · Commercial—Original policy ↗
Adzynma (ADAMTS13, Recombinant-Krhn)2026D0131E · Effective Jul 1, 2026 · Commercial1Original policy ↗
After Hours and Weekend Care Policy, Professional2026R0044A · Commercial6Original policy ↗
Age-Based Codes Policy, ProfessionalEffective Aug 1, 2026 · Commercial2Original policy ↗
Airway Clearance Devices2026T0052OO · Effective Mar 1, 2026 · Commercial6Original policy ↗
Allergen Testing Policy, Professional and Facility2026R8021B · Effective Oct 1, 2026 · Commercial7Original policy ↗
Alpha1-Proteinase Inhibitors2025D0067J · Effective Nov 1, 2025 · Commercial2Original policy ↗

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Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.