UnitedHealthcare Drops Prior Authorization for 1,700 Medical Procedures

UnitedHealthcare has announced that it will be dropping prior authorization for approximately 1,700 medical procedures starting October 1st. However, this change only applies to about 120 codes for Medicare Advantage members, who are the ones most affected by prior authorization denials.

According to a recent analysis by the Kaiser Family Foundation (KFF), UnitedHealthcare denied 17% of standard Medicare Advantage prior authorization requests in 2025, which is the highest rate among six large insurers examined. This means that out of every 100 requests, 17 were denied.

The 1,700 codes that are being removed from prior authorization requirements cover services in cardiology, oncology, rehabilitation, home health, laboratory testing, and durable medical equipment. But it's essential to note that these modifications may not necessarily be beneficial for Medicare Advantage members, as some of the changes may require further scrutiny.

UnitedHealthcare has signaled that there is more to come on this issue, with a target to eliminate 30% of prior authorization volume and nearly two-thirds of prior authorization requirements for pediatric care by the end of this year. The company also aims to process 80% of its prior authorizations in real-time by the end of 2027.