eviCore CT Head/Brain without contrast prior authorization requirements (2026)

What eviCore generally requires to approve CT Head/Brain without contrast (CPT 70450), for Commercial plans. Yes. eviCore generally requires prior authorization for CT Head/Brain without contrast (CPT 70450).

General reference compiled from public sources, last verified 2026-06-13. This is not a coverage determination or medical advice. Always confirm current requirements with eviCore before submitting.

Medical-necessity criteria eviCore generally applies

Non-contrast head CT is appropriate for: acute head trauma (per ACR Head Trauma criteria, including mild TBI meeting a validated clinical decision rule); suspected acute stroke or intracranial hemorrhage; acute neurological change or new focal deficit; and headache with red flags (thunderclap onset, focal neurologic findings, immunocompromise, or known malignancy). Uncomplicated chronic or primary headache without red flags does not meet criteria.

Sources & verification

  • BindingPayer medical policy.View

Binding = the payer's own policy. Proxy = a public, evidence-based clinical guideline the payer mirrors. Portal-only = the binding criteria are confirmed in the administrator's portal. Always confirm against the payer for the member's specific plan. Last verified 2026-06-13.

Frequently asked questions

Does eviCore require prior authorization for CT Head/Brain without contrast?

Yes. eviCore generally requires prior authorization for CT Head/Brain without contrast (CPT 70450).

What does eviCore require to approve CT Head/Brain without contrast?

Non-contrast head CT is appropriate for: acute head trauma (per ACR Head Trauma criteria, including mild TBI meeting a validated clinical decision rule); suspected acute stroke or intracranial hemorrhage; acute neurological change or new focal deficit; and headache with red flags (thunderclap onset, focal neurologic findings, immunocompromise, or known malignancy). Uncomplicated chronic or primary… Always confirm against the current eviCore policy.

How long does a eviCore prior authorization take?

Turnaround varies by plan and submission method. Check the eviCore portal for current timeframes.

Submitting CT Head/Brain without contrast to eviCore?

Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.

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Other eviCore prior authorization requirements

Anterior Cervical Discectomy and FusionArthroplasty (Joint Replacement)Arthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairCardiology - Diagnostic and ImplantsCervical, Lumbar and Thoracic Laminectomy and/or Laminotomy ProceduresCT Abdomen and Pelvis without contrastCT Chest without contrastDorsal Column (Lumbar) Neurostimulators: Trial or ImplantationKnee ArthroscopyKnee MeniscectomyLumbar Spinal FusionMRI Brain without and with contrast

Related guides

Why was my prior authorization denied? Top reasons and how to fix eachHow to write a prior authorization appeal that cites policy