Inpatient rehab (emergency) — prior authorization/notification

Emergency inpatient hospital rehabilitation admissions require prior authorization or notification for the listed UCare programs.

• Applies to emergency inpatient hospital rehab admissions.
• Listed as requiring prior authorization or notification in the UCare 2025 authorization list.

ARMHS — prior authorization/notification

Adult Rehabilitative Mental Health Services (ARMHS) require authorization or notification for the specified UCare programs (MSHO, UCare Connect + Medicare, PMAP, MSC+, MinnesotaCare).

• ARMHS is explicitly listed as requiring prior authorization/notification for MSHO, UCare Connect + Medicare, PMAP, MSC+, and MinnesotaCare.

Durable Medical Equipment (rental & purchase) — prior authorization/notification

Durable medical equipment (DME), including rentals and outright purchases, requires prior authorization or notification as indicated in the UCare authorization list.

• Includes seating/wheelchair rental and purchase and related accessories.
• Listed in the 2025 UCare authorization list as requiring authorization/notification.

Proton beam therapy — prior authorization/notification

Proton beam therapy is listed as a service that requires prior authorization or notification for the applicable UCare programs.

• Proton beam therapy appears in the compiled authorization list and 2025 service list as requiring authorization/notification.

Spinal surgery — prior authorization/notification

Spinal surgery (spine) procedures require prior authorization or notification for the specified product lines per the UCare list.

• Spinal surgery and lumbar spine support procedures are included in the authorization list.
• Spine surgery (nraub qaum) is referenced multiple times across the document as requiring authorization/notification.

Neurostimulation / behavioral health procedures — prior authorization/notification

Neurostimulation and related behavioral health procedures (including vagus nerve stimulation, deep brain stimulation, and TMS) require prior authorization or notification where listed.

• Specifically lists vagus nerve stimulation and deep brain stimulation.
• Transcranial magnetic stimulation (TMS) is included in the 2025 authorization list.

Home health services — prior authorization/notification

Home health nursing and skilled home health visits require prior authorization or notification for MSHO, UCare Connect + Medicare, and UCare Connect.

• Listed as 'home health nursing' (formerly private duty nursing) and skilled home visits in the authorization list.
• Applies only to the specified UCare product lines (MSHO, UCare Connect + Medicare, UCare Connect).

LTAC and PRTF — prior authorization/notification

Long‑term acute care (LTAC) and inpatient psychiatric residential treatment facility (PRTF) admissions require prior authorization or notification for the specified UCare programs.

• LTAC and PRTF are both listed in the UCare authorization list and the 2025 compiled services.
• Applies to the product lines noted in the document (e.g., MSHO, UCare Connect + Medicare, PMAP, MSC+, MinnesotaCare where specified).

SNF admissions — prior authorization/notification

Skilled nursing facility (SNF) admissions and bed placement require prior authorization or notification for the applicable product lines.

• SNF admission and related bed placement are listed as requiring authorization/notification for MSHO and UCare Connect + Medicare.
• SNF and bed placement appear in both the compiled list and the 2025 service list.

Individual & Family product — prior authorization notes

For UCare Individual & Family and UCare Individual & Family with M Health Fairview, selected services (including emergency inpatient rehab and certain spine surgeries) are managed through delegated organizations and require authorization/coordination through those delegated vendors rather than appearing in the central compiled list.

• Individual & Family variants note that orthopedic, dental, and pharmacy services are delegated and therefore not listed in the central authorization table.
• The Individual & Family variant is handled by delegated organizations for the listed types of authorizations.