What's new in Network News
March 25, 2025
UnitedHealthcare Outpatient Procedure Grouper Exhibit annual reimbursement update
Review the 2025 Outpatient Procedure Grouper (OPG) Exhibit for annual changes to reimbursement.
March 24, 2025
Rhode Island Medicaid: OAE testing is not medically necessary for routine hearing screening
Use otoacoustic emissions (OAE) testing only for infants, children under age 4 and some adult populations. Learn why.
March 21, 2025
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.
March 21, 2025
Texas Medicaid: State-required medication prior authorization updates
Effective May 1, 2025, we’re updating Texas Medicaid clinical prior authorization criteria for certain medications.
March 20, 2025
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.
March 20, 2025
Maryland Medicaid: Discarded drugs and biologicals reimbursement policy update
Starting May 1, 2025, UnitedHealthcare Community Plan of Maryland will recognize modifier JZ. Learn more.