New oncology prior authorization codes

Effective Oct. 1, 2023, we’ll require prior authorization for the following colony-stimulating factor medication HCPCS code when administered in outpatient settings as treatment for cancer diagnosis:

These changes affect UnitedHealthcare commercial plans and UnitedHealthcare® Medicare Advantage plans in all states, as well as UnitedHealthcare Community Plan and UnitedHealthcare Individual Exchange* plans in specific states, as outlined below.

UnitedHealthcare Community Plan

UnitedHealthcare Individual Exchange plans

How to submit prior authorization requests 

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 UHCprovider.com/access to get started 
• In the menu, select Prior Authorizations 
• In the Prior Authorization and Notification tool, go to “Create a new notification or prior authorization request” and click Create New Submission 
• Enter the required information and submit 

To support our review, we’ll document clinical requirements within the request submission. You may also be asked to attach medical records. 

Questions?

For questions about oncology prior authorization:

• Email unitedoncology@uhc.com
• Visit our Oncology Prior Authorization and Notification page
• Call oncology prior authorization support at 888-397-8129

* Individual Exchange plans are also referred to as UnitedHealthcare Individual & Family ACA Marketplace plans

PCA-1-23-02015-Clinical-NEWS_06262023