MONTGOMERY– Alabama Medicaid will remove prior authorization requirements for major imaging scans and selected cardiology procedures beginning Nov. 1.

The Alabama Medicaid Agency announced the change in an Oct. 14 provider alert. However, other coverage, eligibility, documentation, and billing requirements remain unchanged.

Which Procedures Are Included?

The agency’s notice lists all procedures in these categories:

• MRI and MRA scans.
• CT and CTA scans.
• PET scans.
• Nuclear cardiology services.
• Diagnostic heart catheterizations.
• Stress echocardiography, also called stress ECHO.

The alert addresses physicians, independent radiologists, hospitals, and other radiology providers.

Service Date Determines the Change

For services performed before Nov. 1, providers must still obtain the required advance approval. Claims without approved authorization will be denied, according to the notice.

Therefore, the change follows the date of service, rather than simply the date a provider submits a bill.

What It Means for Patients and Providers

Prior authorization means approval in advance. For the listed services, the November change removes that administrative step from Alabama Medicaid’s requirements.

However, patients should still discuss their scheduled test with the ordering office or imaging provider. Useful questions include whether the appointment falls under the new policy and what coverage or documentation requirements still apply.

The announcement does not quantify how the change could affect appointment availability or administrative delays. It also does not establish a specific reduction in waiting times at any local hospital or imaging center.

For patients with an upcoming appointment, the provider remains the appropriate place to confirm scheduling details. The policy announcement alone does not establish an individual patient’s eligibility or coverage.

Where Providers Can Get Answers

Providers with policy questions can email medicalservices@medicaid.alabama.gov. For billing questions, the notice directs providers to the Gainwell Technologies Provider Assistance Center at 800-688-7989.

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