UHC Ends Select CT and MRI Site-of-Service Reviews December 1: What Still Needs Authorization?

UnitedHealthcare’s December 1, 2026 change removes a site-of-service review for select CT, MRI and MRA services performed in an outpatient hospital under the plans listed in its notice. It does not eliminate every authorization check. UHC says procedure prior authorization continues when the member’s benefit plan requires the service to be medically necessary for coverage.

For radiology teams and referring practices, the practical task is to separate the location review from the procedure authorization before changing scheduling instructions.

What changes December 1	What still applies
Select outpatient hospital CT, MRI and MRA services no longer receive a site-of-service review under the listed plans.	Procedure prior authorization continues when required by the member’s benefit plan.
The location-review step is removed where the policy applies.	Verify the plan, procedure, service date and facility; this is not an exemption for every UHC product.

The checks to keep before scheduling

• Identify the member’s exact plan and the planned imaging procedure.

• Confirm the service date and whether the imaging will occur in an outpatient hospital.

• Verify the procedure authorization requirement and record the result.

• Update only the location-review step that the policy actually removes.

Which plans and specialties are affected?

The UHC radiology notice specifically lists commercial plans, Individual Exchange Plans, Oxford Plans and UnitedHealthcare Community Plan of North Carolina. Although the page’s heading mentions Community Plans broadly, the detailed list does not establish that all Community products are included. California practices should not assume the change applies to every UHC Medicaid patient.

The named procedures are computed tomography (CT), magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA).

Radiology departments and imaging providers are the direct operational audience. Orthopedics, neurology, oncology and primary care offices may also need to update referral coordination when they order these studies. These are examples of referring specialties, not payer eligibility categories.

What is a site-of-service review?

A site-of-service review considers the setting where care will be delivered. A procedure review considers the planned service itself. A staff member can therefore correctly record that a hospital location review is no longer needed while still needing to resolve authorization for the scan.

Horizon recommends keeping separate fields for those two decisions. A single “authorized” checkbox can hide an incomplete handoff between the ordering office, imaging scheduler and billing team.

How should ordering and imaging offices handle the handoff?

Use a referral note that identifies the planned study, service date, facility and verification outcome. Name the team responsible for the remaining authorization work and where confirmation will be recorded.

If the appointment, facility or procedure changes, revisit the verification. Do not copy an earlier result into a new appointment without checking whether the details still match. Save enough of the portal response or communication to explain the decision later.

For example, removing a location-review task from the scheduling queue should not close an unresolved procedure-authorization task for the same patient. Treat those as separate work items until each has a documented outcome.

What if a claim still denies after December 1?

Compare the denial reason with the member’s plan, date of service, actual procedure and place of service. Determine whether the dispute concerns the location review, procedure authorization or a different billing issue.

If the claim appears inconsistent with the applicable requirements, assemble the verification record, claim and remittance before contacting the payer. Track the response and any corrected payment. Our denial-management guide provides a framework for separating recurring causes and following them through resolution.

How Horizon Can Help With Imaging Claim Follow-Up

Horizon’s full-cycle billing support includes denial investigation, coding support, payer follow-up and payment reconciliation. We help practices connect the information collected before a service with the work needed after a claim is processed.

Call (408) 444-8845 or request a complimentary billing review to identify imaging claim delays caused by missing authorization details, unclear handoffs or unresolved payer adjustments.