UnitedHealthcare prior authorization, page 4

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
37280CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
37282CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
37284CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
37286CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
37288CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
37290CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
37292CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
37294CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
37296CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
37298CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
93653CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
93656CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
E0616CardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
0569TCardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
0570TCardiovascularPrior authorization requirements for UnitedHealthcare commercial plans, Pg 4 Original policy
27412Cerebral seizure monitoring– Inpatient video Electroencephalogram (EEG)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
27415Cerebral seizure monitoring– Inpatient video Electroencephalogram (EEG)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
27416Cerebral seizure monitoring– Inpatient video Electroencephalogram (EEG)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
29866Cerebral seizure monitoring– Inpatient video Electroencephalogram (EEG)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
29867Cerebral seizure monitoring– Inpatient video Electroencephalogram (EEG)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
29868Cerebral seizure monitoring– Inpatient video Electroencephalogram (EEG)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J7330Cerebral seizure monitoring– Inpatient video Electroencephalogram (EEG)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
S2112Cerebral seizure monitoring– Inpatient video Electroencephalogram (EEG)Prior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J0640ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J0641ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J0642ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J1950ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J1952ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J1932ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J9054ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J9072ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J9074ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J9076ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J9172ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J9184ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J9292ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J9304ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
J9324ChemotherapyPrior authorization requirements for UnitedHealthcare commercial plans, Pg 6 Original policy
S9988Clinical trialsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
S9990Clinical trialsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
S9991Clinical trialsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
69710Cochlear and other auditory implantsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
69714Cochlear and other auditory implantsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
69930Cochlear and other auditory implantsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
L8614Cochlear and other auditory implantsPrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
33250Congenital heart diseasePrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
33251Congenital heart diseasePrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
33254Congenital heart diseasePrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
33255Congenital heart diseasePrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 Original policy
33256Congenital heart diseasePrior authorization requirements for UnitedHealthcare commercial plans, Pg 7 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.