In September 2024, UnitedHealthcare began requiring prior authorization for chiropractic services in its Medicare Advantage system. As a result, the Illinois Chiropractic Society pressed our members to involve their patients in helping us fight this onerous requirement.
Now, three years later, UHC announced it will remove that requirement on October 1, 2026. UHC stated, “Effective Oct. 1, 2026, prior authorization will no longer be required for the global CPT® codes listed in the table below for UnitedHealthcare® Medicare Advantage Plans…” Among the listed services are the following:
- “98940 CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS
- 98941 CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS
- 98942 CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS”
Important Note: UHC is only removing the requirement for its Medicare Advantage plans. They will continue to require prior approval for their commercial plans.
It’s About Time
The Illinois Chiropractic Society is pleased that UnitedHealthcare has finally applied to its Medicare Advantage plans what we have known from the beginning: prior authorizations create a barrier to care, impede a patient’s return to health, and increase the cost of care. UHC even admitted in their announcement that: “Removing these prior authorization requirements… remove[s] barriers that can delay care.”
ICS Members – The ICS wants to say THANK YOU for being proactive and getting your patients involved. We know that many insurance policies present obstacles to patients to receive care from your practice, and we believe it was, in part, your efforts that helped convince UHC to overturn this policy. By using the ICS-developed flyers to inform your patients about poor insurance practices, you helped effect change.
What’s Next: Help Patients Advocate for Removal of Prior Authorization from Commercial Plans
Although the ICS is relieved that UHC has removed the PA requirement on their Medicare Advantage plans, we are disappointed that they are leaving these requirements in place for commercial plans, despite their statement that prior authorizations are “barriers that can delay care.”
We need to keep reminding patients with UHC commercial plans about the negative impact of prior authorization barriers. The ICS (along with Chiropractic Future) makes a dedicated flyer available for this purpose.
You can print this flyer in your office and distribute it to the impacted patients: Don’t Let Prior Authorization Delay Your Care. The flyer quickly explains how prior authorization can slow results and negatively affect outcomes.
[Editor’s Note: We have several more flyers that you can use in your office. Read more here.]
Additionally, the Illinois Chiropractic Society continues to work both nationally and at the state level to shape regulatory policy to curb unnecessary barriers to care.
