UnitedHealthcare prior authorization, page 16

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
J2781Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J2782Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J7352Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J0224Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J0584Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J0801Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J0802Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J2507Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J3241Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J0180Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J0217Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J0218Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J0219Injectable medicationsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 14 Original policy
J0221Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J1322Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J1458Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J1743Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J1931Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J2840Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J3397Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J0567Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J1203Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J1809Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J1786Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J3060Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J3385Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J0885Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J1411Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J1412Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J1413Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J3398Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J3399Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J3401Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J3403Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J3404Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J3405Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7170Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7172Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7173Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7174Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7175Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7179Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7180Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7181Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7182Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7183Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7185Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7186Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7187Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 Original policy
J7188Injectable medications (cont.)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 15 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.