New genetic testing codes from the AMA will need prior authorization

The American Medical Association has issued new codes for some genetic and molecular tests. We currently require prior authorization for genetic and molecular tests and beginning Sept. 1. 2025, we’ll require prior authorization for these added codes.

Affected plans

This affects participating UnitedHealthcare commercial plans and UnitedHealthcare Individual Exchange plans in all states.

New procedure codes

The following codes will require prior authorization on Sept. 1:

New procedure codes

How to submit a request

You can submit a prior authorization request through the UnitedHealthcare Provider Portal:

• Go to UHCprovider.com and select Sign In at the top-right corner
• Sign in to the portal using your One Healthcare ID and password
  • If you are a new user and don’t have a One Healthcare ID, visit the Provider Portal registration page to get started
• In the menu, select Prior Authorizations
• In the Prior Authorization and Notification tool, scroll down to “Create a new notification or prior authorization request” and click Create New Submissions
• Enter the required information and submit

Resources

• Genetic and molecular testing prior authorization program information
• Prior Authorization and Notification Interactive User Guideopen_in_new 

Questions? We’re here to help

If you have questions, please visit our Prior Authorization and Notification resources.