April 01, 2023
New oncology prior authorization codes for commercial plans
Effective July 1, 2023, we’ll require prior authorization for the following injectable chemotherapy and antiemetic medication HCPCS codes when administered in outpatient settings as treatment for cancer diagnosis:
| HCPCS code | Description |
|---|---|
| J1456 | Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg |
| J1954 | Injection, leuprolide acetate for depot suspension (lutrate), 7.5 mg |
| J1932 | Injection, lanreotide, (cipla), 1 mg |
Plans this applies to
These changes affect UnitedHealthcare commercial plans and UnitedHealthcare® Medicare Advantage plans in all states, as well as UnitedHealthcare Community Plan in the following states:
| Arizona | Kentucky | Mississippi | Ohio | Tennessee |
| Florida | Louisiana | Nebraska | Pennsylvania | Virginia |
| Hawaii | Maryland | New Jersey | Rhode Island | Washington |
| Kansas | Minnesota | New York | Texas | Wisconsin |
Questions?
For questions about oncology prior authorization:
- Email unitedoncology@uhc.com
- Visit our Oncology Prior Authorization and Notification page
- Call oncology prior authorization support at 888-397-8129
