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Mutual News May 2026 Newsletter
Act
by May 23, 2026 (15 days from notice)
Effective date
Jun 1, 2026
Identified
Jun 20, 2026
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.
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What to do
by May 23, 2026 (15 days from notice) · 4 steps
01Update 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.
02By 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.
03Update encounter forms and staff training.
04Claims submitted without proper authorization will be denied.
Codes mentioned
813548152420912209742098231287312883183032998339884363243633441005054258660647228929089291E0468E0736E1810E1811E1812L67003388237254372563725837260372623726337265372673726937271372733727537277372803728237284372863728837290372923729437296372986233062331630326465464655646566465764658646597047170472704737557792945931459314664568
Original notice
Mutual News May 2026 Newsletter
medmutual.com · Always check the source before changing claims.
Related changes
See all Medical Mutual of Ohio changes →Mutual News November 2026 NewsletterHighEffective Jan 29, 2027 · Mutual News NewsletterMutual News September 2026 NewsletterHighEffective Sep 16, 2026 · Mutual News NewsletterMutual News December 2025 NewsletterHighEffective Jan 28, 2026 · Mutual News NewsletterBrowse every Medical Mutual of Ohio change in the policy list
Related policy hubs
Medical Mutual of Ohio policiesCardiologyNeurosurgeryOrthopedicsRadiologyOncologyPlastic SurgeryVascular SurgeryPain ManagementENT (Ear, Nose & Throat)UrologyOB-GYNCode 81354Code 81524Code 20912Code 20974Code 20982Code 31287Code 31288Code 31830Code 32998Code 33988Code 43632Code 43633Code 44100Code 50542Code 58660Code 64722Code 89290Code 89291Code E0468Code E0736Code E1810Code E1811Code E1812Code L6700Code 33882Code 37254Code 37256Code 37258Code 37260Code 37262Code 37263Code 37265Code 37267Code 37269Code 37271Code 37273Code 37275Code 37277Code 37280Code 37282Code 37284Code 37286Code 37288Code 37290Code 37292Code 37294Code 37296Code 37298Code 62330Code 62331Code 63032Code 64654Code 64655Code 64656Code 64657Code 64658Code 64659Code 70471Code 70472Code 70473Code 75577Code 92945Code 93145Code 93146Code 64568