MedicaidCoverageMedium impact
[Indiana] Evolent Annual Policy Updates - February 2025
CareSource·IN · Radiology·Medical Policy
Effective date
Apr 1, 2025
We identified it
May 9, 2026
Summary
CareSource/Evolent Healthcare is updating three advanced radiology policies for Indiana Medicaid effective April 1, 2025: Cerebral Perfusion CT (CG-015), Unlisted Studies (CG-063), and Low Field MRI (CJ-064). The notice does not specify what changes were made to these policies; practices must review the full policy text on the Magellan Health website for specific coverage, coding, or authorization requirements.
Action Required
By March 31, 2025: Billing team must access and review the three updated policies (CG-015 Cerebral Perfusion CT, CG-063 Unlisted Studies, CJ-064 Low Field MRI) on the Magellan Health website. Identify any changes to coverage criteria, prior authorization requirements, coding guidance, or billing procedures. Update billing system rules, encounter forms, and provider documentation requirements accordingly. Contact CareSource Provider Services at 1-844-607-2831 (Monday-Friday, 7 a.m.–7 p.m. CT) if clarification is needed before the April 1 effective date. Failure to implement required changes may result in claim denials for non-compliant radiology submissions.