Changes to genetic and molecular testing coverage and prior authorization requirements
Update
Last modified: June 19, 2025
Update: The What this means for you section updated to reflect clarifications on prior authorization code notifications.
Starting Jan. 1, 2025, UnitedHealthcare will discontinue coverage for certain codes and remove prior authorization requirements for multi-panel pharmacogenetic codes. This affects select UnitedHealthcare commercial plans and all UnitedHealthcare Exchange plans.
Affected plans
This affects the following UnitedHealthcare benefit plans:
- UnitedHealthcare of the Mid-Atlantic, Inc.
- UnitedHealthcare Plan of the River Valley, Inc.
- UnitedHealthcare Insurance Company of the River Valley
- Oxford Health Insurance, Inc.
- Harvard Pilgrim Health Care
- All Savers Insurance Company
- All Savers Life Insurance Company of California
- UnitedHealthcare Exchange plans
- Neighborhood Health Partnership, Inc.
What this means for you
The following procedure codes will be removed from existing prior authorization/advance notification requirements:
- 0029U
- 0173U
- 0175U
- 0345U
- 0411U
- 0419U
- 0423U
- 0460U
- 0476U
- 0477U
- 81418
Resources
To learn more about this change, access:
- November medical policy bulletin updates
- Advance Notification and Clinical Submission Requirements
- Training: We offer live training sessions for the genetic and molecular testing prior authorization/advance notification program at 10 a.m. CT on the third Thursday of every other month.
Questions?
If you have questions or to register for a live training, please visit our Genetic and Molecular Testing Prior Authorization/Advance Notification Program website.
PCA-1-25-01371-Clinical-WEB_06132025
