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Resources and tools for providers and health care professionals

We invite you to use this website, created especially for health care professionals, to find resources that can help you as you care for your patients. Here you can find our medical policies, stay up to date on the latest news or get training on our many tools and benefit plans.

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News

Ensure PCP assignment to avoid reimbursement denial

UHCCP members must visit a PCP in the same practice (same Tax ID) as the PCP listed on their ID card.

Texas Medicaid: State-required medication prior authorization updates

Effective May 1, 2025, we’re updating Texas Medicaid clinical prior authorization criteria for certain medications.

New Jersey Medicaid: Prior Authorization is required for all Personal Care Assistance services

Per state guidelines, prior authorization is required for all PCA services administered to New Jersey Medicaid members.

Maryland Medicaid: Discarded drugs and biologicals reimbursement policy update

Starting May 1, 2025, UnitedHealthcare Community Plan of Maryland will recognize modifier JZ. Learn more.

New York Medicaid enforces NDC requirements for claims with HCPCS J-codes

Claims for J-code drugs with a UD modifier must include the corresponding National Drug Code to avoid denials.

North Carolina Medicaid: Reimbursement rate changes for personal care services

See how to bill with per diem pricing for personal care services rendered to members living in congregate settings.