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Mutual News May 2026 Newsletter

Medical Mutual of Ohio·Cardiology, Neurosurgery, Orthopedics +8 more·Mutual News Newsletter
Effective date
Jun 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Medical Mutual is implementing major prior authorization changes effective June 2026, including new PA requirements for dozens of CPT codes (imaging, cardiovascular, spine procedures) and removing PA requirements for others. A new reimbursement policy for IMRT radiation therapy is also effective June 1, 2026.

Action Required

Action needed
By May 23, 2026 (15 days from notice): Update billing system to remove prior authorization for CPT codes 0524T, 0667T, 20912, 20974, 20982, 31287, 31288, 31830, 32998, 33988, 43632, 43633, 44100, 50542, 58660, 64722, 89290, 89291, E0468, E0736, E1810, E1811, E1812, L6700, and 0377U. By June 7, 2026 (30 days from notice): Add prior authorization requirements for extensive list of cardiovascular, spine, imaging, and lab codes including 33882, 37254-37298, 62330-62331, 63032, 64654-64659, 70471-70473, 75577, 92945, 93145-93146, and genetic testing codes 0616U-0630U. Update encounter forms and staff training. Claims submitted without proper authorization will be denied.

Affected Billing Codes

81354
81524
20912
20974
20982
31287
31288
31830
32998
33988
43632
43633
44100
50542
58660
64722
89290
89291
E0468
E0736
E1810
E1811
E1812
L6700
33882
37254
37256
37258
37260
37262
37263
37265
37267
37269
37271
37273
37275
37277
37280
37282
37284
37286
37288
37290
37292
37294
37296
37298
62330
62331
63032
64654
64655
64656
64657
64658
64659
70471
70472
70473
75577
92945
93145
93146
64568