
Mar 06, 2025
UnitedHealthcare Updates Prior Authorization Requirements for Specialty Pharmacy Medications in Michigan
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.
























