MedicaidCoverageMedium impact
[Ohio] Evolent Annual Guideline Updates March 2026
CareSource·OH · Radiology, Nuclear Medicine·Medical Policy
Effective date
May 1, 2026
We identified it
May 9, 2026
Summary
CareSource has updated 60+ advanced radiology service policies through its partnership with Evolent Healthcare, effective May 1, 2026. These annual guideline updates cover CT, MRI, CTA, MRA, PET, and specialty imaging procedures across Ohio Medicaid. The specific policy content changes are not detailed in this notification; providers must review updated policies on the Evolent website.
Action Required
By April 15, 2026: Billing and clinical teams must access the Evolent website (https://www1.radmd.com/) to review the full text of all 60 updated radiology policies (ECG 2000-2065, ECG 7272-7337) before the May 1, 2026 effective date. Identify any changes to prior authorization requirements, coverage criteria, medical necessity guidelines, or billing procedures. Update billing software, encounter forms, and provider workflows accordingly. Document all changes in your compliance tracking system. Failure to implement required changes may result in claim denials for Ohio Medicaid members.