All PlansPrior AuthHigh impact
26-253 Evolent Removes Prior Authorization for Select Radiology and Cardiology Services
Health Net·CA · Radiology, Cardiology, Diagnostic Imaging·Prior Authorization
Effective date
May 1, 2026
We identified it
Jun 20, 2026
Summary
Starting May 1, 2026, Evolent will no longer require prior authorization for select radiology and cardiology services including CT scans, MRI studies, and cardiac imaging. This eliminates administrative steps for providers and enables faster patient care for these specific procedures.
Action Required
By May 1, 2026: Billing team must update prior authorization requirements in billing system to remove prior auth for the listed CPT codes (70480-78494). Update encounter forms and provider workflows to reflect that these radiology and cardiology services no longer require prior authorization. Train staff on the new streamlined process to avoid unnecessary delays.