Prior Authorization Coming Soon For Surest Plan Radiology Services
Prior Authorization Coming Soon For Surest Plan Radiology Services
Beginning Oct 01, 2026, Surest, a UnitedHealthcare company, will require prior authorization for certain outpatient radiology services for members enrolled in Surest fully insured or level-funded plans.
This update applies to selected advanced imaging services and is intended to align Surest's prior authorization requirements with those of other UnitedHealthcare commercial plans.
Services That Will Require Prior Authorization
Prior authorization will be required for the following outpatient radiology services:
- Computerized tomography scans
- Magnetic resonance imaging and magnetic resonance angiography
- Nuclear cardiology
- Positron emission tomography scans
What Ordering Providers Should Do
Providers who order any of these outpatient imaging procedures must obtain a prior authorization number before scheduling the service.
This step is important to help avoid claim delays, denials, or payment issues after the service is performed.
What Rendering Providers Should Confirm
Providers who perform advanced outpatient imaging services should confirm that the prior authorization process has been completed before rendering care.
A coverage decision should be issued before the service is provided to help ensure the claim is processed correctly.
Services Not Included In This Requirement
These prior authorization requirements do not apply to advanced imaging services performed in the following settings:
- Emergency room
- Urgent care center
- Observation unit
- Inpatient stay
How To Submit Prior Authorizations
Prior authorizations can be submitted online through the UnitedHealthcare Provider Portal using a One Healthcare ID. Register now.
Providers can also submit or manage prior authorization requests by phone at 866-889-8054, Monday through Friday, 7 a.m. to 7 p.m. local time.
Additional Guidance
Providers should review the 2026 UnitedHealthcare Care Provider Administrative Guide for complete prior authorization details, including urgent requests, retrospective notifications, changes to advanced imaging procedures, and possible claim impacts when authorization is not completed before services are rendered.
For the list of CPT codes and radiology program details, providers should refer to the radiology prior authorization resources and the current UnitedHealthcare Administrative Guide.
