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).
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.
Source
Summarized from ACR Appropriateness Criteria (Head Trauma; Cerebrovascular Disease-Stroke) and eviCore imaging guidelines. Sources: and https://www.evicore.com/provider/clinical-guidelines View the source policy. 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.