UnitedHealthcare Prior Authorization for Imaging: Phone, Portal, Forms
Where to submit a UnitedHealthcare prior authorization for MRI, CT and PET, the phone number to call, the forms and code lists, and the guidelines the reviewer uses.
UnitedHealthcare runs its outpatient radiology prior authorization program through its own provider portal, using eviCore imaging guidelines for commercial and exchange plans.
Prior authorization may be required for CT, MRI, MRA, PET and nuclear cardiology done as an outpatient.
No authorization is needed for imaging done in an emergency room, observation unit, urgent care center or during an inpatient stay.
Medicare Advantage and Dual Special Needs plans do not require prior authorization for CT, MRI or MRA.
Several plan types are excluded from the program, including Oxford, UMR, UnitedHealthcare Shared Services and some self-funded groups; the quick reference guide lists them.
A request needs the member ID and group number, the ordering provider's NPI and tax ID, the CPT codes, the working diagnosis with ICD-10 codes, and the clinical picture with symptoms, duration and treatments tried.
Checked against uhcprovider.com on September 29, 2026. Plans change their vendors and phone numbers; if something here is out of date, tell us.
Guideline sections by body area
The 1579 sections of UnitedHealthcare's imaging guidelines held on this site, grouped by body area. Look up a CPT code to see which apply to a study.
General (1)
CID-14: Wireless Left Atrial Pressure Sensor
Abdomen (242)
AB-18.1: AAA, IAA, Post Endovascular or Open Aortic Repair
AB-17.1: Abdominal Aortic Aneurysm (AAA)
AB-18: Abdominal Aortic Aneurysm (AAA) and Iliac Artery Aneurysm (I...
PVD-8.1: Arterial Evaluation and Venous Mapping Prior to AV Fistula
+ 64 more
Spine (97)
SP-2.12: 3D Rendering
PEDSP-7.1: Achondroplasia
SP-2.1: Anatomic Guidelines
PEDSP-7.3: Atlantoaxial Instability in Trisomy 21 (Down Syndrome)
PEDSP-2.2: Back and Neck Pain in Children Age 5 and Under
PEDSP-2.3: Back and Neck Pain in Children Age 6 and Older
PEDSP-7.4: Basilar Impression
PEDSP-7.5: Chiari Malformation
+ 89 more
Frequently Asked Questions about UnitedHealthcare
UnitedHealthcare runs its outpatient radiology prior authorization program through its own provider portal, using eviCore imaging guidelines for commercial and exchange plans. Submit through the UnitedHealthcare Provider Portal, Prior Authorization and Notification tool.
866-889-8054 (Radiology prior authorization, 7 a.m. to 7 p.m. local time, Monday to Friday (commercial and exchange plans)).
Prior authorization may be required for CT, MRI, MRA, PET and nuclear cardiology done as an outpatient. No authorization is needed for imaging done in an emergency room, observation unit, urgent care center or during an inpatient stay.
Prior Authorization Coverage Lookup
Search 5,229 coverage rules across major insurance payers
