April 01, 2023
Removal of certain requirements for Rhode Island
Updates to prior authorization, notification and medical necessity requirements
Effective June 1, 2023, we’re eliminating prior authorization/notification requirements and/or site of service (SOS) medical necessity reviews for certain surgical, office-based and magnetic resonance imaging (MRI) and computed tomography (CT) procedure codes. This applies to UnitedHealthcare commercial plans in Rhode Island.
What’s changing
These changes will apply to the following categories in our Prior Authorization Requirements for UnitedHealthcare document:
- Site of service (SOS) – Outpatient hospital
- We’ll no longer require prior authorization for these codes
- Site of service (SOS) – Office-based program
- We’ll no longer require prior authorization for these codes
- Radiology
- We’ll no longer require SOS medical necessity review for these codes; however, we’ll still require prior authorization
Questions?
Call Provider Services at 800-666-1353.
