Updated Evolent Authorization Requirements Effective April 1, 2026

As part of the Fidelis Care partnership with Evolent Specialty Services to manage utilization management, this notice informs providers of an important change to prior authorization requirements that took effect on April 1, 2026.

Fidelis Care has removed prior authorization (PA) for the identified Cardiology codes listed below (Table 1) as part of our ongoing work to improve the healthcare experience for our members and provider partners. As of April 1, 2026, these updates establish a more uniform set of PA requirements across all health plan offerings, simplify processes, reduce provider confusion, and support future efforts to expand real-time responses to requests. The affected codes in this communication are managed by Evolent Specialty Services, our utilization management partner.

If you have questions about specific prior authorization codes or how these changes affect your practice, contact your Provider Engagement representative.

Table 1. Radiology and Diagnostic Cardiology codes removed from the Evolent Utilization Review Matrix and no longer require prior authorization for Medicare.

Table listing imaging modalities and corresponding impacted CPT codes.