26-254 Evolent Removes Prior Authorization for Select Radiology and Cardiology Services
Date: 02/27/26
Streamlined access to imaging services begins May 1, 2026
Effective May 1, 2026, several radiology and diagnostic cardiology CPT codes have been removed from Evolent’s Utilization Review Matrix. These services no longer require prior authorization, reducing administrative steps for physicians, practitioners and other providers and supporting more timely delivery of care for patients.
Services that no longer require prior authorization
Modality | Codes |
|---|---|
CT orbit | 70480, 70481, 70482 |
CT maxillofacial/sinus | 70487, 70488, 70486, 76380 |
CT chest | 71250, 71260, 71270, 71271 |
MRI pelvis with dye | 72195, 72196, 72197 |
CT upper extremity | 73200, 73201, 73202 |
MRI upper extremity, other than joint | 73218, 73219, 73220 |
CT lower extremity | 73700, 73701, 73702 |
Fetal MRI | 74712, 74713 |
MRI heart | 75557, 75559, 75561, 75563 |
CT bone density studies | 77078 |
Gated heart planar single | 78472, 78473, 78494 |
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If you have questions regarding the information contained in this update, contact Community Health Plan of Imperial Valley at 833-236-4141.
This information applies to Physicians, Practitioners and Hospitals.
This information applies to Medi-Cal in Imperial County.