UnitedHealthcare's Coverage Criteria for Gattex (Teduglutide) in Pennsylvania: What Counts as "Medically Necessary"?
Answer Box: Getting Gattex Covered by UnitedHealthcare in Pennsylvania
UnitedHealthcare requires prior authorization for Gattex (teduglutide) with strict medical necessity criteria: documented short bowel syndrome, 12+ months of parenteral nutrition dependence (≥3 days/week), failed enteral optimization attempts, and recent colonoscopy with polyp removal. Fastest path to approval: Submit complete