UnitedHealthcare to Drop Pediatric Prior Authorization
The insurer will stop requiring prior authorization for more than 2,000 pediatric care codes for members under 18 starting December 1.
Updated on Nov. 2, 2026 in Children’s Health
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Starting December 1, UnitedHealthcare will no longer require prior authorization for more than 2,000 pediatric care codes covering members under age 18. The change includes CT, MRI, PET, and nuclear cardiology studies, along with radiation therapy delivery codes.
Why it matters
The move follows a May commitment to eliminate nearly two-thirds of pediatric prior authorization requirements. Families and providers may face fewer delays in getting children scheduled for diagnostic imaging and treatment.
The change affects more than 2,000 pediatric care codes, and the insurer previously committed to eliminating nearly two-thirds of pediatric prior authorization requirements. The remaining requirements for certain injectables, genetic tests, surgeries, and state-regulated services have not been detailed in the announcement.
The players
UnitedHealthcare
UnitedHealthcare is a major American health insurance company and a division of UnitedHealth Group that offers commercial, individual exchange, and community health plans.
The details
The policy covers UnitedHealthcare commercial plans, Individual Exchange plans, and Community Plans where state law permits. Imaging codes include CT and MRI of the head, spine, chest, abdomen, pelvis, and extremities, while radiation therapy codes such as proton therapy and stereotactic radiosurgery are also included.
Timeline
May: UnitedHealthcare commits to eliminating nearly two-thirds of pediatric prior authorization requirements.
December 1: Prior authorization is no longer required for the affected pediatric care codes.
Big Picture
The change follows UnitedHealthcare's May commitment to eliminate nearly two-thirds of pediatric prior authorization requirements, extending a broader push by private insurers to reduce preapproval hurdles for children's care. It marks a concrete step beyond that earlier pledge by naming more than 2,000 specific codes.
Families of children under 18 covered by UnitedHealthcare commercial, Individual Exchange, or eligible Community Plans may see fewer waits before CT, MRI, PET, and radiation therapy. Injectable medications, genetic tests, and surgical procedures still require approval under the new policy.
The takeaway
Parents of children covered by UnitedHealthcare should check whether their plan falls under the new policy before scheduling imaging or radiation therapy after December 1. Confirming with the insurer which services still need approval can prevent avoidable delays in care.
What happens next
UnitedHealthcare's prior authorization changes for pediatric care codes take effect December 1.
Further reading
For more on related pediatric care coverage, see Children's Health.
Source note: This article includes information reported by AuntMinnie.
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