UnitedHealthcare to Drop Approvals for Kids' Care
Starting December 1, many pediatric imaging and treatment services under UnitedHealthcare plans will no longer need advance approval.
Updated on Nov. 2, 2026 in Children’s Health
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UnitedHealthcare will stop requiring prior authorization for more than 2,000 pediatric care codes for members under 18, starting December 1. The change covers commercial, Individual Exchange, and Community Plans where state law permits, and follows a May commitment to eliminate nearly two-thirds of pediatric prior authorization requirements.
Why it matters
Prior authorization is a step where insurers must approve a service before care is delivered, and removing it for a large set of children's services can shorten delays in getting imaging and other care for kids. Because the change follows a May commitment, it signals a broader effort to reduce administrative hurdles in pediatric care.
This is a policy announcement from UnitedHealthcare rather than a study, so no trial or cohort results are reported. The figures given are the scope of the change: more than 2,000 pediatric codes and the commitment to eliminate nearly two-thirds of pediatric prior authorization requirements.
The players
UnitedHealthcare
A large U.S. health insurer offering commercial, Individual Exchange, and Community Plans that cover pediatric imaging, radiation therapy, and other care.
The details
The policy removes the advance approval step for pediatric care codes covering CT, MRI, PET, and nuclear cardiology studies, including CT and MRI of the head, spine, chest, abdomen, pelvis, and extremities on commercial plans. Radiation therapy delivery codes, including proton therapy and stereotactic radiosurgery, are also on the list. Certain injectable medications, genetic tests, surgical procedures, and state-regulated services will still require prior authorization.
Timeline
May: UnitedHealthcare committed to eliminating nearly two-thirds of pediatric prior authorization requirements.
December 1: UnitedHealthcare stops requiring prior authorization for pediatric care codes.
Health Landscape
Prior authorization has been a recurring point of friction between insurers and pediatric providers, and this change marks one insurer's move to narrow it for children under 18. Whether other plans follow with similar pediatric reductions will shape how common such limits remain in children's care.
If your child is scheduled for a CT, MRI, PET, or nuclear cardiology study on a UnitedHealthcare plan, the advance-approval step may no longer apply to the listed codes starting December 1. Check with your child's doctor and your plan about whether a specific service or injectable still needs approval.
The takeaway
For families with children on UnitedHealthcare plans, the December 1 change could mean fewer approval delays for many pediatric imaging and radiation services. Ask your child's doctor which services still require prior authorization, since injectables, genetic tests, and surgeries are excluded.
What happens next
UnitedHealthcare's prior authorization removal for pediatric care codes takes effect December 1, when members under 18 will no longer need approval for the listed codes.
Further reading
For more on the broader picture, see Children's Health coverage on how insurance rules affect kids' care.
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