UnitedHealthcare Community Plan
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Please select the state where you practice.

When these medical policies are used to determine medical necessity, clinical guidelines will be applied in the following order:

1) State Medical Policies
2) UnitedHealthcare Medical Policies
3) Milliman Care Guidelines

UnitedHealthcare has developed Medical Policies, Drug Policies, and Coverage Determination Guidelines to assist us in administering health benefits. These policies and guidelines are provided for informational purposes, and do not constitute medical advice.


For state medical policies, please see below.
For UnitedHealthcare Medical Policies, please click here https://www.unitedhealthcareonline.com/b2c/CmaAction.do?channelId=cdc94e74bc62c010VgnVCM100000c520720a____  

For Medicare Medical Policies, please click here.


Clinical Practice Guidelines

UnitedHealthcare has identified and adopted evidence-based clinical guidelines to guide our quality and health management programs. Click here (PDF 220.65 KB) to view the guidelines. 

Provider Advisory Committee Approval - May 31, 2016