Pre-authorization Required for Medicaid Radiologic Imaging
Practitioners must request pre-authorization from the Department of Public Welfare (DPW) for Medicaid advanced radiologic imaging services performed on or after Sept. 1, 2008. Pre-authorization may be obtained over the phone for:
- Computerized tomography (CT) scans
- Magnetic resonance angiogram (MRA) scans
- Magnetic resonance imaging (MRI) scans
- Magnetic resonance spectroscopy (MRS) scans
- Nuclear medicine cardiology scans
- Positron emission tomography (PET) scans
- Single photon emission computed tomography (SPECT) scans
Providers may call (800) 424-4213 between 8 AM and 8 PM Monday through Friday.
This program is only available for services provided in the Voluntary Managed Care and Access Plus areas of the state. It will not be implemented in the mandatory managed care areas, which include the southeast, southwest, central, and Lehigh County areas.
Medicaid is enacting the telephone pre-authorization service to encourage physicians and other practitioners to follow approved, evidenced-based, nationally accepted clinical guidelines for radiology services.
Last Updated: 7/29/2008