This document is an administrative listing of prior authorization (PA) requirements for participating UnitedHealthcare Community Plan of Indiana providers under the Indiana MLTSS Pathways program, effective May 1, 2026. It enumerates CPT/HCPCS codes for bariatric and related services that require PA and summarizes program-level submission channels and routing instructions.
To submit PA requests for the services listed (including bariatric procedures), providers should use the Prior Authorization and Notification tool on the UnitedHealthcare Provider Portal (sign in at UHCprovider.com with a One Healthcare ID) or call 877-610-9785 by phone. Out-of-network requests must be submitted by a network care provider. Prior authorization is not required for emergency or urgent care (see general submission instructions).
The policy specifically lists bariatric procedure CPT codes that require PA (examples include 43644, 43645, 43659, 43770–43775, 43842–43848, 44705, 44799) and notes that some benefit plans include a Center of Excellence requirement for bariatric surgery coverage. Providers should verify plan-specific Center of Excellence requirements prior to referral or PA submission.
For behavioral health or substance use services that require prior authorization, providers must follow the plan-specific routing: call the phone number shown on the member's health plan ID card to refer to the designated behavioral health network. Many benefit plans provide behavioral health coverage through a designated behavioral health network; this routing is distinct from the general PA phone/portal channels.
The document also identifies numerous additional categories that require PA (or notification), such as DME and prosthetics (a long list of E‑, K‑ and Q‑ codes), enteral services (e.g., B4149–B4161), genetic testing (notification/prior authorization required for many molecular/genetic CPT codes), injectable medications (multiple J/Q codes), neurostimulators (e.g., 61850, 61860), non‑emergent air ambulance (A0430/A0431), advanced outpatient imaging (notification prior to scheduling), remote patient monitoring, rhinoplasty, speech therapy, spinal surgery, transplant/CAR T–cell therapies, urine drug testing, VADs and wound vac (see full code lists in the policy).