MedicaidPrior AuthMedium impact
2025.47 - Addition of Prior Authorization on Select Radiology Procedure Codes
Connecticut Medicaid (HUSKY Health)·CT · Cardiology, Radiology, Diagnostic Imaging·Prior Authorization
Effective date
Oct 1, 2025
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid is adding prior authorization requirements for two cardiac MRI procedure codes (C9762 and C9763) for outpatient hospitals effective October 1, 2025. These codes involve cardiac magnetic resonance imaging with strain or stress imaging for assessing heart function.
Action Required
By October 1, 2025: Billing team must update systems to require prior authorization for HCPCS codes C9762 and C9763 for Connecticut Medicaid patients at outpatient hospitals. Contact eviCore healthcare at 1-800-440-5071 for radiology prior authorizations. Update encounter forms to alert providers that these cardiac MRI codes require prior auth. Claims will be denied without proper authorization.