CommercialPrior AuthHigh impact
Fast Facts Newsletter - June (Special Edition) 2025
HealthPartners·MN · Radiology, Diagnostic Imaging·Pharmacy
Effective date
Aug 1, 2025
We identified it
Jun 19, 2026
Summary
HealthPartners is implementing new prior authorization requirements for advanced imaging services (CT, CTA, MRA, MRI, PET) through Cohere Health effective August 1, 2025, and adding new psychotherapy services reimbursement policies. Weight loss medication PA criteria are also being updated with stricter documentation requirements.
Action Required
By July 31, 2025: Billing team must update prior authorization workflows for all advanced imaging services (CT, CTA, MRA, MRI, PET) to route through Cohere Health system instead of HealthPartners. Update encounter forms and EMR alerts to remind providers that prior auth is required for these services. Access Cohere's specific criteria at their guidelines portal and train staff on new submission process. Also implement new psychotherapy services reimbursement policy effective same date. Failure to obtain prior auth through Cohere will result in claim denials.