Radiology policies (NIA)

Female radiologist looking over x-ray

Providers can request prior authorization through the NIA website or by calling the NIA toll-free number, 877-642-0622.

Prior authorization is required for the following outpatient radiology procedures through NIA:

  • CT scan
  • Nuclear Exercise - Tolerance Test (ETT)
  • PET Scan

Radiology policies 2023 Coding Matrix - NIA (PDF)

Radiology policies 2022 Coding Matrix - NIA (PDF)

2023 Magellan advanced imaging guidelines (PDF)

2022 Magellan advanced imaging guidelines (PDF)

Magellan 2023 revision summary crosswalk (PDF)

Prevea360 Health Plan Provider FAQ (PDF)

NIA website

Note: It is the responsibility of the ordering physician or clinic to obtain authorization. Providers rendering the above services should verify that the necessary authorization has been obtained. Failure to do so may result in non-payment of your claim. Imaging procedures performed during an emergency room and/or urgent care visit or in observation and inpatient facilities do not require authorization.