MedicaidPrior AuthMedium impact
26-254 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
Evolent Health is removing prior authorization requirements for 26 specific radiology and cardiology CPT codes effective May 1, 2026. This streamlines access to imaging services including CT scans, MRIs, and cardiac studies, reducing administrative burden for providers.
Action Required
Before May 1, 2026: Billing team must update prior authorization workflows to remove requirements for the 26 specified radiology and cardiology CPT codes. Update billing software rules and staff training materials to reflect that these codes no longer require prior auth for Evolent/Community Health Plan of Imperial Valley Medi-Cal patients. Remove prior auth checkboxes from encounter forms for these specific codes.