Prior authorization coming for Surest plan radiology services

Beginning Oct. 1, 2026, Surest, a UnitedHealthcare company, will require prior authorization for certain outpatient radiology services, listed below, for members on a Surest fully insured or level funded plans:

• Computerized tomography (CT) scans
• Magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA)
• Nuclear cardiology
• Positron emission tomography (PET) scans

These services are currently under prior authorization requirements for other UnitedHealthcare commercial plans and this change will help standardize the approach to these prior authorization submissions.

If you order any of the above outpatient imaging procedures, you’ll need to obtain a prior authorization number prior to scheduling these services. If you render certain advanced outpatient imaging procedures, you’ll need to confirm that the prior authorization process has been completed and a coverage decision has been issued before rendering these services.

UnitedHealthcare is focused on reducing administrative complexity and improving the care experience while ensuring care is safe, effective and affordable for our members. Prior authorization requirements for some codes may be added or removed over time based on decisions made with clinical support.

Prior authorization requirements

View the prior authorization requirement details in the 2026 UnitedHealthcare Care Provider Administrative Guide on page 105, including requirements to follow for:

• Urgent requests
• Retrospective notification
• Provision of additional or modified advanced outpatient imaging procedures
• Claim impacts if you do not complete the prior authorization process or verify that a coverage determination has been issued before rendering these services
  
  

Services not requiring review

These requirements do not apply to advanced imaging in an:

• Emergency room
• Urgent care center
• Observation unit
• Inpatient stay

How to submit and manage prior authorizations

Online

• Sign in to the UnitedHealthcare Provider Portal with your One Healthcare ID
  • If you don’t have a One Healthcare ID, register now
• From the left-hand tabs, select Prior Authorizations

Phone

• 866-889-8054, 7 a.m.–7 p.m., local time, Monday–Friday

Resources

For additional program information, including the list of CPT^® codes requiring prior authorization, visit our Radiology prior authorization resource. For complete details on the radiology protocols, refer to the current UnitedHealthcare Administrative Guide.