Virginia - effective Jan. 1, 2024
Lists behavioral health services and procedure/revenue/CPT codes that require prior authorization for participating behavioral health providers for UnitedHealthcare Exchange Plans members in Virginia effective January 1, 2024. Applies to inpatient and outpatient behavioral health services; emergency/urgent care excluded.
No material clinical/coverage changes — policy remains current with prior authorization requirements unchanged.
Policy summary
This policy requires prior authorization for the listed behavioral health services and associated procedure/revenue/CPT codes for participating providers delivering care to UnitedHealthcare Exchange Plans members in Virginia, effective 2024-01-01. Prior authorization applies to both inpatient and outpatient behavioral health services. Prior authorization is not required for emergency or urgent care. Providers must submit requests via the Prior Authorization and Notification tool on UHCProvider.com (Sign In required).
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.