UHC Prepares to Launch Gold Card Program

On Oct. 1, 2024, UnitedHealthcare (UHC) will launch a National Gold Card Program for qualified practices. UHC recently released a list of Gold-Card-eligible services, which includes CPT 78452 – Myocardial perfusion imaging, tomographic (SPECT).

Provider groups do not need to apply for UHC Gold Card status, but eligibility requirements must be met, including having a prior authorization approval rate of 92 percent or more across all Gold-Card-eligible codes for each of the review years. It is unclear how UHC arrived at its 92 percent threshold or how that threshold would impact eligibility for providers with lower service volume. The lookback period for determining eligibility is 2 consecutive years beginning April 1, 2022, and ending March 31, 2024.

Clinicians may check their UHC Gold Card eligibility through the UHC Provider Portal.

Providers who receive UHC Gold Card status will still need to complete an advance notification for services to be paid. UHC also states in an FAQ that it may require medical records for other non-medical necessity reviews. While Gold Card status may speed up patient access to recommended services, it is currently unclear how much administrative burden on physician practices will be eliminated. ASNC encourages its Gold-Card-eligible members to share feedback and experiences at info@ASNC.org.