New Imaging Program Launches in January

Coming January 1, 2026, Premera Blue Cross has a new program to guide where members get imaging services. Imaging includes computed tomography (CT), computed tomography angiography (CTA), magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA). We’re guiding members to freestanding imaging centers when it’s medically necessary and appropriate.

Why This Matters

The imaging site-of-service program helps members get the right care in the right place. It reviews medical necessity for CT, CTA, MRI, and MRA services. The program explains when these services are medically necessary and when they’re appropriate at the requested location.

How it Works

Premera works with Carelon Medical Benefits Management to review imaging requests. Imaging providers use Carelon’s online tool to request approval and determine location.

Carelon checks if the test is medically necessary and service location:

• Tests can be denied if they’re not medically necessary or the location isn’t appropriate.
• Distance to imaging centers is considered.
• Healthcare providers can contact Carelon for a peer-to-peer conversation if you have questions.
• Imaging centers using billing codes with place of service 11, 49, or 81 must enroll in OptiNet (managed by Carelon) before accepting redirected Premera members.

Questions? Email provider.relations@premera.com.