UnitedHealthcare Expands Prior Auth for Outpatient Procedures: The March 1 Deadline
UHC is adding prior authorization requirements for outpatient surgical procedures and advanced imaging, effective March 1, 2026. Claims submitted without authorization on or after March 1 will deny.
This is one of the more consequential PA expansions UHC has made in the last two years. The affected code categories include high-volume outpatient surgery and imaging that many practices have been billing without PA for years.
What's Changing
- Outpatient surgical procedures — additional musculoskeletal, ENT, and GI procedures now require PA when performed in an ASC or outpatient hospital setting
- Advanced imaging — expanded PA requirements for MRI, CT, and PET scans, including combinations previously exempt
- Sleep studies — new PA requirements for home sleep testing in certain plan types
March 1, 2026 for UHC commercial plans. Medicare Advantage plans may have a staggered rollout — confirm the effective date for each MA plan ID via the UHC provider portal.
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