MedicaidPrior AuthHigh impact
Removal of Prior Authorization Requirements for Radiology and Cardiology Procedures
Alabama Medicaid·AL · Radiology, Cardiology, Nuclear Medicine·Prior Authorization
Effective date
Nov 1, 2026
We identified it
Oct 15, 2026
Summary
Effective November 1, 2026, Alabama Medicaid will remove prior authorization requirements for MRI, MRA, CT, CTA, PET scans, nuclear cardiology services, diagnostic heart catheterizations, and stress echocardiography procedures. Prior to this date, providers must continue obtaining PA before furnishing these services; claims submitted without approved PA will be denied.
Action Required
Before November 1, 2026: Billing team must continue requiring and obtaining prior authorization for all MRI, MRA, CT, CTA, PET scan procedures, nuclear cardiology services, diagnostic heart catheterizations, and stress echocardiography procedures for Alabama Medicaid beneficiaries. Claims submitted without approved PA will be denied. On or after November 1, 2026: Update billing workflows and system configurations to remove PA requirements for these procedures. Verify that billing software no longer requires PA submission for affected radiology and cardiology procedures. Contact Alabama Medicaid Medical Services (medicalservices@medicaid.alabama.gov) or Gainwell Technologies Provider Assistance Center (800-688-7989) with billing questions during the transition.