Genetic and molecular testing prior authorization
This program supports appropriate use of evidence-based clinical genetic and molecular testing to help ensure our members have access to quality care. We review services that require prior authorization for clinical coverage based on medical necessity.

Prior authorization
Please sign in to the UnitedHealthcare Provider Portal to verify if a prior authorization is required for a service and register your laboratory’s tests in the UnitedHealthcare Genetic Test Registry.
For the current list of requirements, visit Advance Notification and Prior Authorization requirements > Current requirements by plan type.
Plans this applies to
Genetic and molecular testing prior authorization requirements apply to the following plans:
- UnitedHealthcare commercial plans, including Neighborhood Health Partnership (NHP), UnitedHealthcare Level Funded, UnitedHealthcare Oxford and UnitedHealthcare of the River Valley
- UnitedHealthcare Individual Exchange plans in all states, except for Colorado
- UnitedHealthcare Community plans in Florida, Hawaii, Kansas, Kentucky, Maryland, Michigan, Mississippi, Missouri, Nebraska, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia, Washington and Wisconsin
Other plans may also have requirements. For more information, refer to the Care Provider Administrative Guides and Manuals.
Resources

Need help?
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