Advanced Imaging Policies
Draft Imaging Policies
There are no policies currently in draft status.
Comment on Draft Imaging Policies
To ensure that the development of medical policies occurs through an open, collaborative process, we welcome comments about medical policies that are in the draft stage.
Providers are invited to submit scientific, evidence-based information, professional consensus opinions and other information supported by medical literature relevant to draft policies for consideration. Comments are accepted for 45 days from the posting date listed on the draft policy.
How to Submit Comments
Make sure your voice is heard by providing feedback directly to us:
-
Complete our online medical policy feedback form, or
-
Send comments by mail or fax to:
Medical Director's Office
Patrius Health
Attn: Health Management - Medical Policy
P.O. Box 12364
Birmingham, AL 35202-2364
Fax: 205-220-0878
Previous Imaging Policies
For a copy of previous imaging policies, email MedicalBenefitsManagement.Guidelines@Carelon.com, indicating the specific dates and guidelines needed.
Precertification of Advanced Imaging Services
Some advanced imaging services require precertification. Click the link below to view a list of applicable CPT/HCPCS codes.
Advanced Imaging CPT Codes Requiring Precertification
Blue Advantage Advanced Imaging Policies
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Blue Advantage Genetic Testing Policies
► Click here to return to the Blue Advantage Genetic Testing Policies page
Blue Advantage Radiation Therapy Policies
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Draft Radiation Therapy Policies
Patrius Health partners with eviCore (formerly CareCore National LLC) to administer radiation therapy solutions for our customers.
EviCore is our business associate and is an independent company that provides specialty benefit management services. EviCore has agreed to follow Patrius Health’s privacy and security policies regarding the confidentiality and protection of your personal health information.
Draft Radiation Therapy Policies
Effective for dates of service on and after July 15, 2025, the following updates will apply to the eviCore Radiation Oncology Guidelines.
Summary of Changes to eviCore Radiation Oncology Guidelines Effective July 15, 2025
Comment on Draft Policies
To ensure that the development of medical policies occurs through an open, collaborative process, we welcome comments about medical policies that are in the draft stage.
Providers are invited to submit scientific, evidence-based information, professional consensus opinions and other information supported by medical literature relevant to draft policies for consideration. Comments are accepted for 45 days from the posting date listed on the draft policy.
How to Submit Comments
Make sure your voice is heard by providing feedback directly to us:
-
Complete our online medical policy feedback form, or
-
Send comments by mail or fax to:
Medical Director's Office
Patrius Health
Attn: Health Management - Medical Policy
P.O. Box 12364
Birmingham, AL 35202-2364
Fax: 205-220-0878
Draft Genetic Testing Policies
Effective for dates of service on or after June 15, 2025, the changes listed in the document below will apply to Carelon Genetic Testing Clinical Appropriateness Guidelines. As part of the Carelon guidelines semi-annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe and affordable healthcare services.
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Comment on Draft Policies
To ensure that the development of medical policies occurs through an open, collaborative process, we welcome comments about medical policies that are in the draft stage.
Participating providers are invited to submit scientific, evidence-based information, professional consensus opinions and other information supported by medical literature relevant to these draft policies for consideration.
Comments are accepted for 45 days from the posting date listed on the draft policy.
Make sure your voice is heard by providing feedback directly to us:
- Complete our online medical policy feedback form, or
- Send comments by mail or fax to:
Patrius Health
Attn: Health Management - Medical Policy
P.O. Box 12364
Birmingham, AL 35202-2364
Fax: 205-220-0878
Precertification of Genetic Testing Services
Some genetic testing services require precertification. Click the link below to view a list of applicable CPT/HCPCS codes.