Change in Evolent Review Scope | Diagnosis Code Range & All Ordering Provider Specialties
Beginning January 1, 2026, Evolent’s review scope for ConnectiCare radiation oncology and oncology-related infused chemotherapeutic drugs, supportive agents, symptom management medications rendered in provider office, ambulatory center and outpatient hospital settings will be updated to include the following diagnosis codes and now apply to all ordering provider specialties: C00-D09.0, D37.01-D49.9, D61.810, D61.82, D63.0, D64.0-64.81, D70.1, D72.822, D75.81, E34.0, Z41.8
Change in Evolent Submission Portal for ConnectiCare Radiation Oncology Treatment Requests
Beginning January 1, 2026, providers must begin submitting radiation oncology requests through the Evolent CarePro provider portal, evolent.com/provider-portal, for services scheduled on or after January 1, 2026.
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There are no changes to the request process for oncology drug requests currently being submitted to Evolent through the Evolent CarePro provider portal, evolent.com/provider-portal.
Prior authorization requests can also be submitted to Evolent by telephone, Monday – Friday, from 8:00 a.m. to 8:00 p.m. EST:
1.888.999.7713, option 2, medical oncology 1.888.999.7713, option 3, radiation oncology ConnectiCare approvals issued before January 1, 2026, are effective until the authorization expiration date. Upon expiration, authorization requests must be submitted to Evolent. |
