UnitedHealthcare is updating its prior authorization requirements for genetic and molecular testing. Starting October 1, 2026, two new CPT codes issued by the American Medical Association (AMA) will be added to the list of codes that require prior authorization before the test can be performed.

The two codes being added are 0648U and 0651U. These are either newly issued AMA codes or codes that were previously classified as unproven.

The change affects providers working with several specific UnitedHealthcare plans across all states. The plans included Neighborhood Health Partnership, Inc., UnitedHealthcare Level Funded, UnitedHealthcare Oxford, UnitedHealthcare of the River Valley, and UnitedHealthcare exchange plans.

Providers who need to submit or manage prior authorization requests for these codes can do so through the UnitedHealthcare Provider Portal at secure.uhcprovider.com. Logging in requires a One Healthcare ID, and providers who do not yet have one will need to register before they can access the portal. Once logged in, prior authorization requests can be found under the "Prior Authorizations and Notifications" tab on the left side of the screen.

UnitedHealthcare is also offering training resources for providers unfamiliar with the prior authorization process. A Prior Authorization and Notification Interactive Guide is available online.

One important point for providers to keep in mind: if a prior authorization request is not submitted before the date of service, the claim will be denied. Providers will also not be allowed to bill the patient for the denied amount.

For additional information, providers can visit UnitedHealthcare's Genetic and Molecular Testing Prior Authorization page or review the UnitedHealthcare Commercial and Individual Exchange Medical Policies. Questions can also be directed to the Prior Authorization and Notification resource section on the UnitedHealthcare provider website.