Anthem changes coverage policy for MRIs, CT scans at hospitals

Indianapolis-based Anthem stopped covering outpatient MRIs and CT scans at hospitals without prior approval, according to the Indianapolis Business Journal.

Anthem wants its members to avoid hospital imaging services and instead opt for a cheaper alternative at a freestanding facility.

Hospitals will need to submit a precertification request for any patient receiving an MRI or CT scan at the hospital. The imaging service will only be covered at the hospital if Anthem deems the request medically necessary.

The policy took effect July 1 in Indiana, Wisconsin, Missouri and Kentucky. On Sept. 1, the policy will expand into Ohio.

The insurer has not disclosed the amount of money it expects to save or what prompted the policy change, according to the report.

To learn more about the change in policy, read the FAQ from Anthem. 

Copyright © 2023 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Webinars

Featured Whitepapers

Top 40 articles from the past 6 months