Removal of Prior Authorization Requirements for Radiology and Cardiology Procedures

TO: Physicians, Independent Radiologists, Hospitals and Other Radiology Providers

RE: Removal of Prior Authorization Requirements for Radiology and Cardiology Procedures

Effective November 1, 2026, the Alabama Medicaid Agency (Medicaid) will remove prior authorization (PA) requirements for all MRI, MRA, CT, CTA and PET scan procedures, as well as nuclear cardiology services, diagnostic heart catheterizations, and stress echocardiography (ECHO) procedures.

For services rendered prior to November 1, 2026, providers must obtain PA before furnishing these services to Medicaid beneficiaries. Claims submitted without approved PA will be denied. Information regarding PA requirements and submission procedures can be found in Chapter 22 of the Provider Billing Manual.

All other Medicaid coverage, eligibility, documentation and billing requirements remain unchanged.

Providers with policy questions may contact Medical Services at [email protected].

Providers with billing questions may contact the Gainwell Technologies Provider Assistance Center at 800-688-7989.