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Getting the latest healthcare news for you
Getting the latest healthcare news for you
UnitedHealthcare is dropping prior authorization requirements for roughly 1,700 service codes starting October 1, spanning commercial, Medicare Advantage, Medicaid, and ACA plans. The move is part of the insurer's broader pledge to eliminate 30% of prior auth requirements by end of 2026. Services affected include cardiology, genetic testing, chiropractic care, physical therapy, orthopedics, and more.
UnitedHealthcare is making good on its promise to cut red tape. Starting October 1, the insurance giant will eliminate prior authorization requirements for approximately 1,700 CPT codes across its commercial, Medicare Advantage, Medicaid, and ACA individual market plans. The affected services span a wide range of clinical areas — cardiology, genetic and lab testing, chiropractic care, physical and occupational therapy, and orthopedic procedures, among others. The largest share of changes applies to community plans in Texas, North Carolina, and Rhode Island.
This is the latest step in UHC's broader commitment to eliminate 30% of prior auth requirements by the end of 2026 — a goal announced in May. The insurer is also launching a rural prior authorization waiver program on November 1 and speeding up payments by up to 50% for roughly 1,400 rural and Critical Access Hospitals.
By the Numbers:
Why it matters: Prior authorization delays are a top frustration for both patients and physicians. By removing pre-approval requirements for thousands of routine services, UHC could meaningfully reduce care delays and administrative burden — though critics note that denial rates remain a concern.
