UnitedHealthcare prior authorization, page 12

Requirements

Commercial, Medicare Advantage, Community Plan, and Exchange each need their own source. This page does not use one requirement sentence for all four. The long descriptor is blank because no AMA-licensed CPT file was available to copy.

Commercial

Prior authorization codes

Prior authorization codes
CodeDescriptionSource
0238UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0239UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0242UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0244UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0245UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0250UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0265UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0268UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0271UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0272UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0273UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0274UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0276UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0288UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0289UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0306UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0307UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0318UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0319UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0320UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0326UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0334UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0355UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0364UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0378UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0379UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0388UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0389UGenetic and molecular testing to include BRCA gene testingPrior authorization requirements for UnitedHealthcare commercial plans, Pg 12 Original policy
0391UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0395UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0398UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0409UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0425UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0426UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0444UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0449UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0465UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0473UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0474UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0475UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0478UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0481UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0483UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0484UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0485UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0487UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0493UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0495UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0499UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy
0500UGenetic and molecular testing to include BRCA gene testing (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 13 Original policy

UnitedHealthcare commercial advance notification and prior authorization requirements

Medicare Advantage

No reviewed Medicare Advantage code row is on this page. Medicare Advantage does not inherit the commercial row above.

Community Plan

No reviewed Community Plan code row is on this page. Community Plan does not inherit the commercial row above.

Exchange

No reviewed Exchange code row is on this page. Exchange does not inherit the commercial row above.

Forms

UnitedHealthcare prior authorization and advance notification plan requirements

Updates

Commercial removal supplement
CodeLong descriptorCode systemPlan scopeOutcomeSource
0006MCPTCommercial plans covered by the October removal supplementRemovedNo under this removal notice, effective October 1, 2026Removal does not establish coverage or code billability; check member-specific exceptions.p. 1, Global CPT codes; introduction establishes removal of PA.

Sources

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.