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.

Checking prior authorization for J3490? Open UnitedHealthcare’s official lists and confirm the member’s product there.

17 policies name J3490, those listing the fewest codes first. A policy that names a code may also list it as excluded.

UnitedHealthcare policies
PolicyDetailsCodesSource
Ketalar® (Ketamine) and Spravato® (Esketamine)2026D0069Q · Effective May 1, 2026 · Commercial2Original policy ↗
Medications/Drugs (Outpatient/Part B)MMP057.57 · Effective Oct 1, 20262Original policy ↗
Lumvoa™ (Veligrotug-Vvze) and Tepezza® (Teprotumumab-Trbw)2026D0089M · Effective Oct 1, 2026 · Commercial3Original policy ↗
Oxlumo® (Lumasiran) and Rivfloza® (Nedosiran)2026D0102K · Effective Jun 1, 2026 · Commercial3Original policy ↗
Review at Launch for New to Market Medications2025D0060K · Effective Dec 1, 2025 · Commercial3Original policy ↗
Subcutaneous Implantable Naltrexone Pellets2026D0078H · Effective Jan 1, 2026 · Commercial6Original policy ↗
Chelation Therapy2026T0051EE · Effective Jul 1, 2026 · Commercial8Original policy ↗
Ustekinumab2026D0045AB · Effective Jul 1, 2026 · Commercial15Original policy ↗
Sodium Hyaluronate2026D0081M · Effective Oct 1, 2026 · Commercial18Original policy ↗
Supply Policy, ProfessionalCommercial19Original policy ↗
White Blood Cell Colony Stimulating Factors2026D0061AE · Effective Sep 1, 2026 · Commercial20Original policy ↗
[Prior Authorization] UnitedHealthcare Community Plan Michigan Medicaid Prior Authorization Requirements - April 2026Effective Apr 1, 2026 · Medicaid1,232Original policy ↗
UnitedHealthcare Medicare Advantage/ Peoples Health and Rocky Mountain Health Plans prior authorization requirementsEffective Jan 1, 2026 · Medicaid1,534Original policy ↗
Peoples Health Plans prior authorization requirementsEffective May 1, 2026 · Medicaid1,538Original policy ↗
Prior authorization requirements for UnitedHealthcare CompleteEffective May 1, 2026 · Commercial2,151Original policy ↗
Prior Authorization Requirements for UnitedHealthcareEffective Jan 1, 2026 · Commercial2,174Original policy ↗
Prior authorization requirements for UnitedHealthcare CompleteEffective Jan 1, 2026 · Commercial3,105Original policy ↗

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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.

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