UnitedHealthcare Updates Prior Authorization Requirements for Specialty Pharmacy Medications in Michigan
Michigan members of UnitedHealthcare Community Plan must request prior authorization or notification for all specific provider-administered medications that require it. Treatment changes have been deployed to cover a wide variety of therapies because they meet the medical necessity standards.
Affected Medications
The following medications will now require prior authorization:
NameDrug | HCPCS code |
Briumvi™ | J2329 |
Corticotropin® Gel | J0802 |
Daxxify® | J0589 |
Eylea™ HD | J0177 |
Izervay™ | J2782 |
Leqembi™ | J0174 |
Panzyga® | J1576 |
Pombiliti™ | J1203 |
Qalsody™ | J1304 |
Rystiggo™ | J9333 |
Syfovre™ | J2781 |
Tofidence™ | Q5133 |
Tzield™ | J9381 |
Veopoz™ | J9376 |
Vyjuvek™ | J3401 |
Vyvgart® Hytrulo™ | J9334 |
How to Submit a Prior Authorization Request
Providers can submit prior authorization requests through the UnitedHealthcare website by following these steps:
- Visit uhcprovider.com and sign in.
- Select Prior Authorizations from the top menu.
- Choose the option to create a new prior authorization submission from the available menu.
- Select Specialty pharmacy from the dropdown menu.