New Oncology Prior Authorization Code Requirement Announced

May 07, 2026

1 minute

New Oncology Prior Authorization Code Requirement Announced

Effective October 01, 2026, prior authorization will be required for HCPCS code J2860, Injection, siltuximab, 10 mg, when administered in an outpatient setting for the treatment of a cancer diagnosis.

HCPCS code	Description
J2860	Injection, siltuximab, 10 mg

This update is being made to align with procedure code changes from CMS and/or the American Medical Association.

Affected plans

The prior authorization requirement will apply to:

UnitedHealthcare commercial plans
UnitedHealthcare Medicare Advantage plans in all states
UnitedHealthcare Community Plan in select states
UnitedHealthcare Individual Exchange plans, also known as UnitedHealthcare Individual & Family ACA Marketplace plans, in select states

UnitedHealthcare Community Plan

Arizona
Colorado
Florida
Hawaii
Kansas
Kentucky
Louisiana
Maryland
Mississippi
Nebraska
New Jersey
New Mexico
New York
Ohio
Pennsylvania
Rhode Island
Tennessee
Texas
Virginia
Washington
Wisconsin

UnitedHealthcare Individual Exchange plans

Alabama
Arizona
Colorado
Louisiana
Maryland
Michigan
Missouri
Mississippi
North Carolina
Nebraska
Florida
Georgia
Indiana
New Jersey
New Mexico
New York
Ohio
Oklahoma
South Carolina
Tennessee
Illinois
Iowa
Kansas
Texas
Virginia
Washington
Wisconsin
Wyoming

Questions and support

Providers with questions can contact UnitedHealthcare oncology support by emailing unitedoncology@uhc.com, visiting the Oncology Prior Authorization and Notification page, or calling oncology prior authorization support at 888-397-8129.

Services

Credentialing

Credentialing is the rigorous process of verifying a healthcare provider’s qualifications, including their education, training, licenses, and clinical experience. This service ensures that practitioners meet the high standards required by insurance networks and hospitals to provide care and receive reimbursement.

Billing & Collection

Billing and Collection service involves confirming a patient’s insurance coverage, active status, and specific benefits before their appointment. By identifying co-pays, deductibles, and required prior authorizations upfront, staff can prevent claim denials and help patients understand their financial responsibilities.

Eligibility Verification

Eligibility verification is the process of verifying a patient’s health insurance coverage and benefits to determine what services are covered and the level of coverage available. This process is essential for healthcare providers to ensure that they receive proper reimbursement for services rendered and that patients are not left with unexpected medical bills.

Revenue Cycle Management

RCM is the financial process that manages the entire lifecycle of a patient’s account, from the initial appointment scheduling to the final balance payment. It integrates eligibility, coding, billing, and collections into a single, cohesive workflow aimed at maximizing a practice's profitability.

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