MedicaidPrior AuthHigh impact
COVID-19: Radiology - Chest CT Scans
Missouri Medicaid (MO HealthNet)·MO · Radiology, Pulmonology, Emergency Medicine +1 more·Provider Notice
Effective date
May 12, 2023
We identified it
Jun 20, 2026
Summary
Starting May 12, 2023, MO HealthNet will require prior authorization for chest CT scans (codes 71250, 71260, 71270) when used with COVID-19 related diagnoses, ending the emergency waiver that allowed these without prior auth. Additionally, all radiology prior authorizations will be reduced from 90-day to 30-day approval periods.
Action Required
By May 12, 2023: Billing team must update system to require prior authorization for HCPCS codes 71250, 71260, and 71270 when paired with COVID-19 related diagnosis codes. Update radiology authorization tracking to reflect new 30-day approval periods instead of 90-day periods. Notify radiology department and providers that chest CT scans for COVID-related diagnoses now require prior auth. Claims will be denied without proper prior authorization.