Prior Authorization Cuts by UnitedHealthcare Are Not for Thee

UnitedHealthcare this week said it will make a 30 percent reduction in the number of items and services requiring prior authorization across its Medicare Advantage (MA) and Dual Eligible Special Needs Plans, Community Plans (Medicaid managed care), and commercial insurance products.

But don’t get too excited, says Nicole Fallon, vice president of integrated services and managed care policy for LeadingAge, because the association’s review of the more than 1,700 affected codes “found that few apply to skilled nursing facilities [SNFs] or home health agencies [HHAs].”

She called this “a disappointing, though perhaps unsurprising, result for members.”

Fallon said in a blog post that there are three CPT Codes—92597, 92508, and 92526—that address speech-language pathology services and treatment of swallowing dysfunction and/or oral function for feeding that will be affected by the prior authorization cutback.

“There are also some codes for home-based durable medical equipment like patient lifts and hospital beds that will no longer need to be pre-approved. These new prior authorization policies will take effect October 1,” she said.

UnitedHealthcare signed a June 2025 pledge along with other insurers to reduce prior authorizations across all of their insurance products, “but to date, these efforts typically ignore offering any relief for post-acute care providers like SNFs and HHAs. This latest proposal and other announcements made earlier in the year appear to be their attempt to follow through on their public commitment,” Fallon said.

Get the complete rundown of the prior authorization landscape via the Fallon blog post.

Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.