CommercialPrior AuthMedium impact
26-255 Evolent Removes Prior Authorization for Select Radiology and Cardiology Services
Health Net·CA · Radiology, Cardiology·Prior Authorization
Effective date
May 1, 2026
We identified it
Jun 20, 2026
Summary
Effective May 1, 2026, Evolent Health Net is removing prior authorization requirements for multiple radiology and cardiology diagnostic services including CT scans, MRIs, and cardiac studies. This will streamline ordering and reduce administrative burden for these specific imaging procedures.
Action Required
By May 1, 2026: Update billing system and prior authorization workflows to remove pre-approval requirements for the specified radiology and cardiology CPT codes. Train staff to stop requesting prior authorization for these services. Update encounter forms and EMR templates to reflect these changes.