CurrentUnitedHealthcarePolicy ADMINISTRATIVE 300.1

Oxford Administrative and Medical (Clinical) Policies

Governs that Oxford Commercial plan membership will use UnitedHealthcare Commercial Medical Policies starting January 1, 2026; affects Oxford Commercial members and policy administrators. Oxford will keep Administrative Policies accessible as before but will no longer maintain duplicate Oxford-specific clinical policies.

Policy Summary

PayerUnitedHealthcare

PolicyOxford Administrative and Medical (Clinical) Policies

Policy CodePolicy ADMINISTRATIVE 300.1

Change TypeOperational changenew administrative policy

Effective DateJanuary 1, 2026

Next Review Date

Key ActionProviders should reference UnitedHealthcare Commercial Medical Policies on UHCprovider.com for prior authorization and clinical coverage rules for Oxford Commercial members.

SourceLink

POLICY UPDATE CHANGES

Effective January 1, 2026, Oxford will utilize the UnitedHealthcare Commercial Medical Policies and will no longer maintain duplicate Oxford-specific Medical (Clinical) Policy versions.

New Administrative Policy created effective January 1, 2026.

Jan 1, 2026effective date for policy change

Oxford Commercialapplicable lines of business

Nonerelated policies listed

Policy Applicability and Sourcing

Policy applicability and sourcing

Applicability and sourcing

ALL of the following

Oxford Commercial plan membership will follow UnitedHealthcare Commercial Medical Policies for medical/clinical policy decisions starting January 1, 2026.
UnitedHealthcare Commercial Medical Policies may be accessed at UHCprovider.com/policies > For Commercial Plans > Medical & Drug Policies.
Oxford will no longer maintain duplicate Oxford-specific Medical (Clinical) Policy versions effective January 1, 2026.
Oxford Administrative Policies will remain externally accessible as they were prior to January 1, 2026 and will continue to govern administrative procedures.

Policy Summary

PayerUnitedHealthcare

PolicyOxford Administrative and Medical (Clinical) Policies

Policy CodePolicy ADMINISTRATIVE 300.1

Change TypeOperational changenew administrative policy

Effective DateJanuary 1, 2026

Next Review Date

Key ActionProviders should reference UnitedHealthcare Commercial Medical Policies on UHCprovider.com for prior authorization and clinical coverage rules for Oxford Commercial members.

SourceLink

On This Page

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.

Oxford Administrative and Medical Policies

Oxford Administrative Policies and Medical (Clinical) Policies — definitions and notes

Primary clinical policy sourceEffective January 1, 2026, Oxford will utilize the UnitedHealthcare Commercial Medical Policies (available at UHCprovider.com/policies > For Commercial Plans > Medical & Drug Policies).

Oxford clinical policy maintenanceOxford will no longer maintain duplicate Oxford-specific Medical (Clinical) Policy versions as of January 1, 2026.

Oxford Administrative PoliciesOxford Administrative Policies will remain accessible externally with the same access that existed prior to January 1, 2026; Oxford will continue to maintain administrative policies.

Applicability to membershipThis sourcing applies to Oxford Commercial plan membership.

Self-funded and insured product exceptionsCertain policies may not apply to Self-Funded members and some insured products; the member-specific benefit plan document or Certificate of Coverage governs if differences exist.

Policy modification and authorityOxford reserves the right to modify policies as necessary without prior written notice unless otherwise required by administrative procedures or applicable state law; 'Oxford' includes Oxford Health Plans, LLC and subsidiaries.

OpenPayer

Oxford Administrative and Medical (Clinical) Policies

Policy Applicability and Sourcing

Where to Find Applicable Medical Policies

Oxford Administrative and Medical Policies