Applies to CPT (Current Procedural Terminology) Codes 81422 and 81479

Starting June 01, 2025, UnitedHealthcare Community Plan of Maryland will require prior authorization for two types of Non-Invasive Prenatal Testing (NIPT) to comply with state requirements.

This change applies to CPT codes 81422 and 81479 when used for the following procedures:

• NIPT for trisomy screening and sex chromosomal analysis
• NIPT for trisomy screening, sex chromosomal analysis (SCA), and microdeletions

How to Submit a Prior Authorization Request

Prior authorization requests can be submitted through the UnitedHealthcare Provider Portal by following these steps:

• Go to UHCprovider.com and select Sign In at the top right corner
• Log in using your One Healthcare ID and password
  • If you are a new user and do not have a One Healthcare ID, visit the provider portal registration page to get started
• From 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
• Fill in the required information and submit

If a prior authorization request is not submitted before the date of service, the claim will be denied, and you will not be able to balance bill the member.

Resources

• Maryland Department of Health Non-Invasive Prenatal Testing clinical criteria for coverage determination guidelines, documentation requirements, and additional information
• Prior Authorization and Notification Interactive User Guide

Questions?

For any questions, visit our Prior Authorization and Notification page.