UnitedHealthcare policy

UnitedHealthcare Medicare Advantage/ Peoples Health and Rocky Mountain Health Plans prior authorization requirements

UnitedHealthcare Medicare Advantage/ Peoples Health and Rocky Mountain Health Plans prior authorization requirements is a public UnitedHealthcare policy (effective Jan 1, 2026). It lists 1,534 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

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Payer
UnitedHealthcare
Effective
Jan 1, 2026
Line of business
Medicaid
Source
www.uhcprovider.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.

CodeOther UnitedHealthcare policies
00012Policies naming 00012
00300Policies naming 00300
00303Policies naming 00303
00304Policies naming 00304
00305Policies naming 00305
00306Policies naming 00306
00307Policies naming 00307
00308Policies naming 00308
00309Policies naming 00309
00310Policies naming 00310
00744Policies naming 00744
00746Policies naming 00746
00748Policies naming 00748
00749Policies naming 00749
00750Policies naming 00750
00758Policies naming 00758
0200TPolicies naming 0200T
0201TPolicies naming 0201T
09000Policies naming 09000
09001Policies naming 09001
09100Policies naming 09100
09102Policies naming 09102
09103Policies naming 09103
09117Policies naming 09117
09118Policies naming 09118
11960Policies naming 11960
11971Policies naming 11971
12268Policies naming 12268
12350Policies naming 12350
12404Policies naming 12404
12405Policies naming 12405
12406Policies naming 12406
12408Policies naming 12408
12413Policies naming 12413
12414Policies naming 12414
12416Policies naming 12416
12417Policies naming 12417
12418Policies naming 12418
12422Policies naming 12422
12423Policies naming 12423
12424Policies naming 12424
12428Policies naming 12428
12429Policies naming 12429
12430Policies naming 12430
12433Policies naming 12433
12434Policies naming 12434
12435Policies naming 12435
12437Policies naming 12437
12438Policies naming 12438
12440Policies naming 12440
12442Policies naming 12442
12443Policies naming 12443
12444Policies naming 12444
12445Policies naming 12445
12446Policies naming 12446
12826Policies naming 12826
12834Policies naming 12834
12835Policies naming 12835
12840Policies naming 12840
12986Policies naming 12986
12987Policies naming 12987
12988Policies naming 12988
13295Policies naming 13295
13296Policies naming 13296
13353Policies naming 13353
13354Policies naming 13354
13355Policies naming 13355
13464Policies naming 13464
13465Policies naming 13465
13466Policies naming 13466
13467Policies naming 13467
13470Policies naming 13470
13483Policies naming 13483
13517Policies naming 13517
13518Policies naming 13518
13519Policies naming 13519
13522Policies naming 13522
13523Policies naming 13523
13546Policies naming 13546
13711Policies naming 13711
13804Policies naming 13804
13850Policies naming 13850
13852Policies naming 13852
13875Policies naming 13875
13895Policies naming 13895
13896Policies naming 13896
14000Policies naming 14000
14001Policies naming 14001
14041Policies naming 14041
15304Policies naming 15304
15305Policies naming 15305
15306Policies naming 15306
15307Policies naming 15307
15330Policies naming 15330
15331Policies naming 15331
15336Policies naming 15336
15337Policies naming 15337
15375Policies naming 15375
15403Policies naming 15403
15404Policies naming 15404
15405Policies naming 15405
15406Policies naming 15406
15408Policies naming 15408
15409Policies naming 15409
15410Policies naming 15410
15412Policies naming 15412
15413Policies naming 15413
15414Policies naming 15414
15415Policies naming 15415
15416Policies naming 15416
15417Policies naming 15417
15418Policies naming 15418
15424Policies naming 15424
15425Policies naming 15425
15426Policies naming 15426
15428Policies naming 15428
15429Policies naming 15429
15451Policies naming 15451
15550Policies naming 15550
15605Policies naming 15605
15606Policies naming 15606
15627Policies naming 15627
15628Policies naming 15628
15629Policies naming 15629
15630Policies naming 15630
15631Policies naming 15631
15632Policies naming 15632
15633Policies naming 15633
15634Policies naming 15634
15635Policies naming 15635
15636Policies naming 15636
15637Policies naming 15637
15638Policies naming 15638
15639Policies naming 15639
15640Policies naming 15640
15641Policies naming 15641
15642Policies naming 15642
15643Policies naming 15643
15644Policies naming 15644
15645Policies naming 15645
15646Policies naming 15646
15648Policies naming 15648
15672Policies naming 15672
15673Policies naming 15673
15725Policies naming 15725
15726Policies naming 15726
15727Policies naming 15727
15728Policies naming 15728
15734Policies naming 15734
15735Policies naming 15735
15736Policies naming 15736
15737Policies naming 15737
15738Policies naming 15738
15739Policies naming 15739
15740Policies naming 15740
15741Policies naming 15741
15742Policies naming 15742
15743Policies naming 15743
15747Policies naming 15747
15748Policies naming 15748
15750Policies naming 15750
15757Policies naming 15757
15758Policies naming 15758
15774Policies naming 15774
15775Policies naming 15775
15776Policies naming 15776
15780Policies naming 15780
15781Policies naming 15781
15782Policies naming 15782
15783Policies naming 15783
15784Policies naming 15784
15785Policies naming 15785
15786Policies naming 15786
15787Policies naming 15787
15788Policies naming 15788
15789Policies naming 15789
15790Policies naming 15790
15791Policies naming 15791
15792Policies naming 15792
15793Policies naming 15793
15795Policies naming 15795
15802Policies naming 15802
15820Policies naming 15820
15822Policies naming 15822
15823Policies naming 15823
15830Policies naming 15830
15877Policies naming 15877
15878Policies naming 15878
15879Policies naming 15879
15894Policies naming 15894
15895Policies naming 15895
15937Policies naming 15937
15938Policies naming 15938
16175Policies naming 16175
16188Policies naming 16188
16190Policies naming 16190
16191Policies naming 16191
16205Policies naming 16205
16206Policies naming 16206
16207Policies naming 16207
16208Policies naming 16208
16233Policies naming 16233
16234Policies naming 16234
16235Policies naming 16235
16236Policies naming 16236
16325Policies naming 16325
16326Policies naming 16326
16327Policies naming 16327
17064Policies naming 17064
17107Policies naming 17107
17108Policies naming 17108
17999Policies naming 17999
19303Policies naming 19303
19316Policies naming 19316
19318Policies naming 19318
20930Policies naming 20930
20931Policies naming 20931
20974Policies naming 20974
20975Policies naming 20975
20979Policies naming 20979
21120Policies naming 21120
21121Policies naming 21121
21122Policies naming 21122
21123Policies naming 21123
21125Policies naming 21125
21127Policies naming 21127
21141Policies naming 21141
21142Policies naming 21142
21143Policies naming 21143
21145Policies naming 21145
21146Policies naming 21146
21147Policies naming 21147
21150Policies naming 21150
21151Policies naming 21151
21154Policies naming 21154
21155Policies naming 21155
21159Policies naming 21159
21160Policies naming 21160
21172Policies naming 21172
21175Policies naming 21175
21179Policies naming 21179
21180Policies naming 21180
21181Policies naming 21181
21182Policies naming 21182
21183Policies naming 21183
21184Policies naming 21184
21188Policies naming 21188
21193Policies naming 21193
21194Policies naming 21194
21195Policies naming 21195
21196Policies naming 21196
21198Policies naming 21198
21199Policies naming 21199
21206Policies naming 21206
21210Policies naming 21210
21215Policies naming 21215
21230Policies naming 21230
21235Policies naming 21235
21240Policies naming 21240
21242Policies naming 21242
21244Policies naming 21244
21245Policies naming 21245
21246Policies naming 21246
21247Policies naming 21247
21248Policies naming 21248
21249Policies naming 21249
21255Policies naming 21255
21256Policies naming 21256
21260Policies naming 21260
21261Policies naming 21261
21263Policies naming 21263
21267Policies naming 21267
21268Policies naming 21268
21275Policies naming 21275
21299Policies naming 21299
21685Policies naming 21685
21899Policies naming 21899
22100Policies naming 22100
22101Policies naming 22101
22102Policies naming 22102
22110Policies naming 22110
22112Policies naming 22112
22114Policies naming 22114
22206Policies naming 22206
22207Policies naming 22207
22210Policies naming 22210
22212Policies naming 22212
22214Policies naming 22214
22220Policies naming 22220
22222Policies naming 22222
22224Policies naming 22224
22532Policies naming 22532
22533Policies naming 22533
22548Policies naming 22548
22551Policies naming 22551
22554Policies naming 22554
22556Policies naming 22556
22558Policies naming 22558
22590Policies naming 22590
22595Policies naming 22595

And 1,234 more in the original policy.

All UnitedHealthcare policies · UnitedHealthcare prior authorization CPT list

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.