UnitedHealthcare said earlier this year that it was aiming to eliminate 30% of prior authorization requirements by the end of 2026.
Now, the insurance giant is offering a deeper look at codes that will no longer be subject to prior auth as of Oct. 1, including adjustments across its commercial, Medicaid, Medicare Advantage and individual market coverage. About 1,700 codes are included overall.
The bulk of CPT codes no longer subject to prior auth are concentrated in UHC's commercial and individual plans, according to the notices. The number of codes varies across the 17 states and the District of Columbia where UHC offers community plans, with the largest share in Texas, North Carolina and Rhode Island.
"Removing these prior authorization requirements is part of our effort to help reduce administrative work, remove barriers that can delay care and give you more time to focus on patient care," UHC said.
The insurer made the commitment to slash prior auth requirements in May, including codes for common outpatient surgeries and diagnostic tests like echocardiograms. At the time, UnitedHealth emphasized that just 2% of services are subject to prior auth, and 92% of submissions are approved.
UnitedHealthcare CEO Tim Noel said in May that the changes are "one more way we are working to make it easier for patients to get the care they need when they need it and ensure doctors can spend more time with their patients."
“Prior authorization is an essential safeguard but should only be used when it truly protects patients and improves care,” Noel said in a statement.
UnitedHealth was one of many insurers to sign on to a broad industry pledge to reform prior authorization that was unveiled last summer, and an update from AHIP and the Blue Cross Blue Shield Association in April suggests that plans have overall reduced prior auths by 11% under that pledge.
A recent report from KFF did throw cold water on some of the improvements that insurers have touted over the past year. The analysts estimated that plans denied between 12% and 18% of standard prior authorization requests in 2025, ranging from 12% in Medicare Advantage to 18% in the Affordable Care Act exchange segment.
In that study, UnitedHealth had the highest rate of denials for standard requests in MA at 17%.