UnitedHealthcare coverage policies

UHC-POL-surgical-ablative-procedures-venous-insufficiency-varicose-veins

Surgical and Ablative Procedures for Venous Insufficiency and Varicose Veins

Effective Jul 1, 2026

UHC-DENT-SURGICAL-EXTRACTION-ERUPTED-TEETH-RETAINED-ROOTS

Surgical and Partial Extractions of Erupted Teeth and Removal of Retained Roots

UHC-DENT-SURGICAL-ENDODONTICS

Surgical Endodontics

UHC-DENT-SURGICAL-EXTRACTION-IMPACTED-TEETH

Surgical Extraction of Impacted Teeth

UHC-DENT-SURGICAL-PERIODONTICS-MUCOGINGIVAL-PROCEDURES

Surgical Periodontics: Mucogingival Procedures

UHC-DENT-SURGICAL-PERIODONTICS-RESECTIVE-PROCEDURES

Surgical Periodontics: Resective Procedures

UHC-POL-susvimo

Susvimo (Ranibizumab Injection)

Effective Aug 1, 2026

UHC-EXCH-MD-SUSVIMO

Susvimo (Ranibizumab Injection) – Commercial and Individual Exchange Medical Benefit Drug Policy

UHC-EXCH-MD-SYMPATHETIC-BLOCKADE

Sympathetic Blockade

UHC-POL-sympathetic-blockade

Sympathetic Blockade

Effective Sep 10, 2026

UHC-COMM-MD-SYNAGIS-PALIVIZUMAB-CS

Synagis (Palivizumab) – Community Plan Medical Benefit Drug Policy

UHC-COMM-RP-UHCCP-T-STATUS-CODES-POLICY

T Status Codes

UHC-EXCH-RP-COMM-T-STATUS-CODES-POLICY

T Status Codes

UHC-POL-COMM-T-Status-Codes-Policy

T Status Codes Policy, Professional

UHC-CG-T-CELL-RECEPTOR-T-CELL-THERAPY-E8C31A90C7

T-Cell Receptor T-Cell Therapy

UHC-CG-T-CELL-RECEPTOR-T-CELL-THERAPY-FOR-OHIO-ONLY-38BEBF52FB

T-Cell Receptor T-Cell Therapy (for Ohio Only)

UHC-EXCH-RP-COMM-TELEHEALTH-POLICY-FACILITY

Telehealth

UHC-POL-COMM-Telehealth-Policy-Facility

Telehealth Policy, Facility

UHC-EXCH-RP-COMM-TELEHEALTH-AND-TELEMEDICINE-POLICY

Telehealth/Virtual Health Policy, Professional

UHC-POL-COMM-Telehealth-and-Telemedicine-Policy

Telehealth/Virtual Health Policy, Professional

UHC-COMM-RP-UHCCP-TELEHEALTH-VIRTUAL-HEALTH-POLICY-PROFESSIONAL-AND-FACILITY-R7133

Telehealth/Virtual Health Policy, Professional and Facility

UHC-COMM-MD-TEPEZZA-CS

Tepezza (Teprotumumab-Trbw) – Community Plan Medical Benefit Drug Policy

UHC-EXCH-MD-TEPEZZA-IEX

Tepezza (Teprotumumab-Trbw) – Individual Exchange Medical Benefit Drug Policy

UHC-COMM-RP-UHCCP-TESTOSTERONE-POLICY

Testosterone Policy, Professional and Facility

UHC-EXCH-RP-COMM-TESTOSTERONE-POLICY

Testosterone Policy, Professional and Facility

UHC-POL-COMM-Testosterone-Policy

Testosterone Policy, Professional and Facility

UHC-POL-testosterone-replacement-supp-therapy

Testosterone Replacement or Supplementation Therapy

Effective Jan 1, 2026

UHC-COMM-MD-TESTOSTERONE-REPLACEMENT-SUPPLEMENTATION-THERAPY-CS

Testosterone Replacement or Supplementation Therapy – Community Plan Medical Benefit Drug Policy

UHC-EXCH-MD-TESTOSTERONE-REPLACEMENT-SUPP-THERAPY-IEX

Testosterone Replacement or Supplementation Therapy – Individual Exchange Medical Benefit Drug Policy

UHC-POL-tezspire

Tezspire (Tezepelumab-Ekko)

Effective Feb 1, 2026

UHC-COMM-MD-TEZSPIRE-CS

Tezspire (Tezepelumab-Ekko) – Community Plan Medical Benefit Drug Policy

UHC-EXCH-MD-TEZSPIRE-TEZEPELUMAB-IEX

Tezspire (Tezepelumab-Ekko) – Individual Exchange Medical Benefit Drug Policy

UHC-COMM-RP-UHCCP-TIME-SPAN-CODES-POLICY-R0102

Time Span Codes

UHC-EXCH-RP-COMM-TIME-SPAN-CODES-POLICY

Time Span Codes Policy, Professional

UHC-POL-COMM-Time-Span-Codes-Policy

Time Span Codes Policy, Professional

UHC-CG-TOBACCO-USE-04AF8D53D8

Tobacco Use

UHC-COMM-MD-TOCILIZUMAB-CS

Tocilizumab – Community Plan Medical Benefit Drug Policy

UHC-POL-tocilizumab

Tocilizumab Injection for Intravenous Infusion

Effective Jul 1, 2026

UHC-EXCH-MD-TOCILIZUMAB-INJECTION-FOR-INTRAVENOUS-INFUSION-IEX

Tocilizumab Injection for Intravenous Infusion – Individual Exchange Medical Benefit Drug Policy

UHC-DENT-TOPICAL-MED-CARIES-PREVENTION-REMINERALIZATION

Topical Medicaments for Caries Prevention or Remineralization

UHC-COMM-MD-TOTAL-ARTIFICIAL-DISC-REPLACEMENT-SPINE-CS

Total Artificial Disc Replacement for the Spine