Posted in Insurance, Training, Updates

MVP Plans (NY) High Tech Radiology Policy Changes -2021

As of January 1, 2021 the following MVP Plans will no longer require prior authorization for High Tech Radiology Services:

MVP Medicare Advantage Plans

MVP Medicaid Managed Care

MVP Harmonious Health Plan (HARP)

MVP Child Health Plus (CHP)

These services include: MRI/MRA, PET Scan, Nuclear Cardiology, CT/CTA, and 3D Rendering Imaging Services

This applies only to the services rendered by IN Network Providers. For any of the above mentioned plans that do have Out of Network benefits and would like to go to an out of network provider: the Prior Authorization is Required!

To request an authorization: please complete a Prior Approval Request Form (PARF) and fax it to MVP at 1-800-280- 7346.

ALL other MVP plans still require a prior authorization for HIGH Radiology Services. To request an Auth please contact eviCore Healthcare by submitting requests at evicore.com or by calling 1-800-568-0458.

#MRI, #MRA, #PET, #MVPCHP, #MVPHARP

Posted in Insurance, Updates

UHC-Computer Tomography code S8092 Update, for 2021

Effective 01/01/2021- CT code S8092, also known as ultrafast ct, cine ct, will not be subject to site of care/service medical necessity review.

This update/change will apply to UHC Commercial Plans including:

Oxford, Neighborhood Health Partnership and UnitedHealthcare of the River Valley

HCPCS code S8092 code is still subject to prior notification/authorization (medical necessity review).

UnitedHealthcare West or Sierra, at this time, are excluded from this policy update.

If you would like to read the whole the whole medical policy, Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) Scan – Site of Service, click here.