Radiology Prior Authorization for Federal Employee Plan Moves to Carelon January 2027
Beginning January 1, 2027, Premera Blue Cross will transition prior authorization for certain radiology services to Carelon Medical Benefits Management (Carelon) for Federal Employee Program (FEP) members in Washington.
Why it Matters
Providers will need to visit Carelon’s provider portal to submit prior authorization for certain services.
What’s Changing
Carelon will manage prior authorization for select radiology services, including the following:
- Computed tomography (CT)
- Computed tomography angiography (CTA)
- Functional magnetic resonance imaging (fMRI)
- Magnetic resonance imaging (MRI)
- Magnetic resonance angiography (MRA)
- Magnetic resonance spectroscopy (MRS)
- Positron emission tomography (PET)
- Nuclear cardiology
- Stress echocardiography
- Resting echocardiography
- Transesophageal echocardiography (TEE)
Services performed in an inpatient setting or during an emergency room visit are excluded from the program.
Prepare for the Transition
For services scheduled through December 31, 2026, continue requesting prior authorization through Premera. Authorizations completed before January 1, 2027, will be honored after the change. Starting December 21, 2026, you can contact Carelon for authorization of services scheduled on or after January 1, 2027.
If a provider wants prior authorization for a date of service on January 1, 2027 or after, you can submit the request anytime starting December 21, 2026. Register anytime to access the portal.
Explore More
- Submit requests, verify order numbers, or check status in Carelon’s provider portal (available 24/7).You can also call 866-666-0776, Monday to Friday, 10 a.m. to 8 p.m. Central Time.
- Visit Carelon MBM Radiology for clinical guidelines, order-entry checklists, and resources.
- Find more tools and information in our Carelon provider resources.