UnitedHealthcare Cancer Supportive Care - Colony Stimulating Factors prior authorization requirements (2026)
What UnitedHealthcare generally requires to approve Cancer Supportive Care - Colony Stimulating Factors (CPT J0185, J0897, J1442, J1447, J1448, J1453, J1454, J1627, J2506, Q5101, Q5108, Q5110, Q5111, Q5120, Q5122, Q5125, Q5136, Q5157, Q5158, Q5159), for Commercial plans. Yes. UnitedHealthcare generally requires prior authorization for Cancer Supportive Care - Colony Stimulating Factors (CPT J0185, J0897, J1442, J1447, J1448, J1453, J1454, J1627, J2506, Q5101, Q5108, Q5110, Q5111, Q5120, Q5122, Q5125, Q5136, Q5157, Q5158, Q5159).
Medical-necessity criteria UnitedHealthcare generally applies
Patient has cancer diagnosis requiring colony-stimulating factor drugs administered in outpatient setting. Codes J0897, J1442, J1447, J2506, J2820, Q5101, Q5110, Q5111, Q5120, Q5122 also require prior authorization for non-oncology diagnosis.
Commonly required documentation
- Clinical documentation including cancer diagnosis, treatment plan, chemotherapy regimen
How to submit
- Method: portal
- Portal: UnitedHealthcare
- Typical turnaround: about 3 days
Source
Prior authorization required for colony-stimulating factor drugs and bone-modifying agents administered in outpatient setting for cancer diagnosis. Call 888-397-8129 for assistance. Last verified 2026-05-06.
Frequently asked questions
Does UnitedHealthcare require prior authorization for Cancer Supportive Care - Colony Stimulating Factors?
Yes. UnitedHealthcare generally requires prior authorization for Cancer Supportive Care - Colony Stimulating Factors (CPT J0185, J0897, J1442, J1447, J1448, J1453, J1454, J1627, J2506, Q5101, Q5108, Q5110, Q5111, Q5120, Q5122, Q5125, Q5136, Q5157, Q5158, Q5159).
What does UnitedHealthcare require to approve Cancer Supportive Care - Colony Stimulating Factors?
Patient has cancer diagnosis requiring colony-stimulating factor drugs administered in outpatient setting. Codes J0897, J1442, J1447, J2506, J2820, Q5101, Q5110, Q5111, Q5120, Q5122 also require prior authorization for non-oncology diagnosis. Always confirm against the current UnitedHealthcare policy.
How long does a UnitedHealthcare prior authorization take?
UnitedHealthcare typically decides Cancer Supportive Care - Colony Stimulating Factors requests in about 3 days. Timeframes vary; check the payer portal.
Submitting Cancer Supportive Care - Colony Stimulating Factors to UnitedHealthcare?
Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.