MedicaidPrior AuthHigh impact
Provider Notification - Prior Authorization Updates
Aetna Better Health of Virginia·VA · Cardiology, Internal Medicine·Prior Authorization
Effective date
Jan 15, 2026
We identified it
Aug 13, 2026
Summary
Effective January 15, 2026, Aetna Better Health of Virginia is removing prior authorization requirements for 21 echocardiography and Doppler ultrasound CPT codes in the cardiovascular category. Billing teams must update their systems to stop requiring prior authorization for these codes and inform providers that these procedures can now be billed directly without pre-approval.
Action Required
By January 15, 2026: Billing team must update the billing system and ProPat authorization module to REMOVE prior authorization requirements for the 16 listed cardiovascular echocardiography CPT codes (93303, 93304, 93306, 93307, 93308, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, 93350, 93351). Update claim submission workflows to allow these codes to bypass prior authorization checkpoints for Aetna Better Health of Virginia Medicaid plans. Notify providers and clinical staff that these echocardiography procedures no longer require pre-authorization. Failure to update systems may result in unnecessary claim delays or denials due to outdated authorization holds.