UnitedHealthcare to Institute Site of Care Reviews for Certain Advanced Outpatient Imaging Procedures

Beginning with dates of service on or after Jan. 1, 2019, once prior authorization is requested for certain advanced outpatient imaging procedures (CT and MR) in accordance with its Outpatient Radiology Notification/Prior Authorization Protocol, UHC will review the site of care. UHC will not conduct site of care reviews if the procedure is planned to be performed in a outpatient freestanding imaging facility or an office setting.

Site of care reviews will apply to providers in all states, except Iowa, Kentucky and Utah. Site of Care reviews will apply to UnitedHealthcare commercial benefit plans, including exchange benefit plans and the following benefit plans: Neighborhood Health Partnership, UnitedHealthcare of the River Valley, UnitedHealthcare.