From Oct. 1, UnitedHealthcare will drop prior authorization for roughly 1,700 procedure codes across five business lines, but only about 120 apply to Medicare Advantage and Dual Special Needs plans; waiving authorization does not guarantee coverage.
The 1,700 total combines separate, overlapping lists for UnitedHealthcare’s business lines, so a code removed for one plan type may still require authorization under another. KFF’s August 2026 review of 2025 disclosures found UnitedHealth Group denied 17% of standard Medicare Advantage authorization requests, the highest rate among six large insurers studied; their average was 12%. KFF cautioned that member and service mix can skew comparisons. A UnitedHealthcare spokesperson told Healthcare Dive that selected codes were weighted toward services with high existing approval rates; the company did not say whether frequently denied services were included.
Across insurers in KFF’s study, 67% of appealed standard Medicare Advantage denials were overturned, although the article says denials are rarely appealed. UnitedHealthcare management said it had committed to reducing prior-authorization volume by 30% and pediatric prior-authorization requirements by nearly two-thirds by year-end; it set a separate target to process 80% of authorizations in real time by the end of 2027.
