Payer Policy Updates

UnitedHealthcare’s Medicare Advantage prior authorization cuts by category

UnitedHealthcare is cutting 20 percent of its prior authorizations in two waves. The first cuts take effect Sept. 1 and the second phase goes into effect Nov. 1.

By: Andrew Cass

Friday, August 18th, 2023

Here are the number of cuts UnitedHealthcare is making to its Medicare Advantage prior authorization requirements, broken down by category. See the individual codes being eliminated here.

Effective Sept. 1

Breast reconstruction (non-mastectomy): 18

Hysterectomy: 2

Spin surgery: 2

Vein procedures: 4

Durable medical equipment: 129

Orthotics/prosthetics: 305

Effective Nov. 1

Radiology: 61

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