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South Carolina Implementation Update: The planned August 1, 2026 expansion for South Carolina members has been postponed. Current prior authorization requirements will remain unchanged for this membership. Additional information, including a revised effective date, will be communicated as soon as it becomes available.

Changes for Market Place, Medicaid and Medicare Members

Molina Healthcare is expanding collaboration with Evolent as the administrator of the Advanced Imaging programs in the listed applicable markets on August 1, 2026 and September 1, 2026. 

What does this mean for providers?

Prior authorization through Evolent will be required for the following advanced imaging services, when ordered by any provider specialty, for applicable Molina markets and members: .

• CT / CTA  

• MRI / MRA 

• PET scans 

Evolent’s authorization review scope for services above is based on a defined list of applicable CPT codes. Providers should verify PA requirements using Molina Healthcare’s PA Lookup Tool.

10/1 Applicable Markets and Members

Prior authorization requirements apply to the following markets on August 1, 2026:

8/1 and 9/1 Applicable Markets and Members

Prior authorization requirements apply to the following markets on August 1 and September 1, 2026:

Submitting Prior Authorizations

Providers should submit all new prior authorization requests, for applicable markets and members, to Evolent using one of the following methods on and after the market effective date:  

• Log in to the Evolent RadMD provider portal at radmd.com

• Telephone submission available

Markets with an October 1, 2026 effective date:  ID

Authorizations issued by the health plan before October 1, 2026 for Molina members are effective until the authorization expiration date. Providers should submit all new prior authorization requests to Evolent for services scheduled on or after October 1, 2026.

Markets with a September 1, 2026 effective date: CT, IL, KY, MI and WI

Authorizations issued by the health plan before September 1, 2026 for Molina members are effective until the authorization expiration date. Providers should submit all new prior authorization requests to Evolent for services scheduled on or after September 1, 2026.

Markets with an August 1, 2026 effective date:  IA, NV, and UT

Authorizations issued by the health plan before August 1, 2026 for Molina members are effective until the authorization expiration date. Providers should submit all new prior authorization requests to Evolent for services scheduled on or after August 1, 2026.

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