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MedicaidPrior AuthMedium impact

Changes to Prior Authorization Requirements for Advanced Imaging and Nuclear Cardiology Services

Connecticut Medicaid (HUSKY Health)·CT · Cardiology, Diagnostic Imaging, Nuclear Medicine +1 more·Prior Authorization
Effective date
Jul 1, 2016
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (HUSKY A, B, C, D) is eliminating prior authorization requirements for all nuclear cardiology services and for advanced imaging (CT, MRI, PET) services for patients 18 and under, effective July 1, 2016. Adult patients 19+ will still need prior authorization for advanced imaging in outpatient settings.

Action Required

Action needed
By July 1, 2016: Billing team must update prior authorization workflows for Connecticut Medicaid patients. Remove prior auth requirements for all nuclear cardiology procedures (CPT codes 78451-78496) for all ages. Remove prior auth requirements for advanced imaging (CT, MRI, PET) for patients 18 and under only. Continue requiring prior auth for advanced imaging for patients 19+ in outpatient settings.

Affected Billing Codes

78451
78452
78453
78454
78459
78466
78468
78469
78472
78473
78481
78483
78491
78492
78494
78496
70450
70460
70470
70480
70481
70482
70486
70487
70488
70490
70491
70492
70496
70498
71250
71260
71270
71275
72125
72126
72127
72128
72129
72130
72131
72132
72133
72191
72192
72193
72194
73200
73201
73202
73206
73701
73702
74150
74160
74170
74174
74175
74176
74177
74178
74261
74262
74263
75571
75572
75573
75574
75635
76380
77078
70336
70540
70542
70543
70544
70545
70546
70547
70548
70549
70551
70552
70553
70554
70555
71550
71551
71552
71555
72141
72142
72146
72147
72148
72149
72156
72157
72158
72159
72195
72196
72197
72198
73218
73219
73220
73221
73222
73223
73225
73718
73719
73720
73721
73722
73723
73725
74181
74182
74183
74185
75557
75559
75561
75563
75565
76390
77058
77059
77084
78608
78609
78811
78812
78814
78815
78816

Related policy hubs

Connecticut Medicaid (HUSKY Health) policiesCT policy changesCardiologyDiagnostic ImagingNuclear MedicineRadiologyCode 78451Code 78452Code 78453Code 78454Code 78459Code 78466Code 78468Code 78469Code 78472Code 78473Code 78481Code 78483Code 78491Code 78492Code 78494Code 78496Code 70450Code 70460Code 70470Code 70480Code 70481Code 70482Code 70486Code 70487Code 70488Code 70490Code 70491Code 70492Code 70496Code 70498Code 71250Code 71260Code 71270Code 71275Code 72125Code 72126Code 72127Code 72128Code 72129Code 72130Code 72131Code 72132Code 72133Code 72191Code 72192Code 72193Code 72194Code 73200Code 73201Code 73202Code 73206Code 73701Code 73702Code 74150Code 74160Code 74170Code 74174Code 74175Code 74176Code 74177Code 74178Code 74261Code 74262Code 74263Code 75571Code 75572Code 75573Code 75574Code 75635Code 76380Code 77078Code 70336Code 70540Code 70542Code 70543Code 70544Code 70545Code 70546Code 70547Code 70548Code 70549Code 70551Code 70552Code 70553Code 70554Code 70555Code 71550Code 71551Code 71552Code 71555Code 72141Code 72142Code 72146Code 72147Code 72148Code 72149Code 72156Code 72157Code 72158Code 72159Code 72195Code 72196Code 72197Code 72198Code 73218Code 73219Code 73220Code 73221Code 73222Code 73223Code 73225Code 73718Code 73719Code 73720Code 73721Code 73722Code 73723Code 73725Code 74181Code 74182Code 74183Code 74185Code 75557Code 75559Code 75561Code 75563Code 75565Code 76390Code 77058Code 77059Code 77084Code 78608Code 78609Code 78811Code 78812Code 78814Code 78815Code 78816