South Carolina Prior Authorization Requirements for UnitedHealthcare Exchange Plans — Behavioral Health
Lists behavioral health services and procedure codes that require prior authorization for UnitedHealthcare Exchange plan members in South Carolina; applies to participating behavioral health providers requesting inpatient and outpatient authorizations.
No material clinical or coverage changes in this revision.
Coverage and Authorization Rules
Authorization requirement
Covered when prior authorization is obtained for the listed services and codes per member benefit plan.
Member-specific benefit plan must be referenced; prior authorization is not required for emergency or urgent care; members have no non-emergent out-of-network coverage and no coverage outside the service area.
Prior authorization is not required for emergency or urgent care. For the Exchange plan benefit designs covered by this document, members do not have non‑emergent out‑of‑network coverage and have no coverage outside of the service area.
Revenue and CPT Code Lists
| Rev 114 | Inpatient Mental Health |
| Rev 124 | Inpatient Mental Health |
| Rev 134 | Inpatient Mental Health |
| Rev 144 | Inpatient Mental Health |
| Rev 154 | Inpatient Mental Health |
| Rev 204 | Inpatient Mental Health |
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