Medical necessity criteria of outpatient hospital services.

Effective 1 January, 2020, UnitedHealthcare requires certain procedures and advanced imaging take place in a non-hospital affiliated outpatient facility.

Anesthesia

Cardiology

Diagnostic

Drugs & Biologicals

Durable Medical Equipment

Home Health

Hospice

Hospital Related Services

Imaging

Laboratory

Oncology

Ophthalmology

Orthopaedics

Surgery & Injections

Therapeutics

Vaccines

Noncovered

Services/Items