August 5, 2021
Effective August 1, 2021, prior authorizations are required for advanced imaging and cardiology services program for members of the Highmark health plan, an out-of-area Blue Plan. BlueCard® members can be identified by the suitcase
logo on the member ID card and the health plan name is typically located in the top right corner.
The Highmark program includes prior authorization for elective or non-emergency outpatient radiology or cardiac imaging services. This does not apply to services that are performed in the emergency room or during an inpatient stay. Services include:
| Radiology |
Cardiac Imaging |
| Magnetic resonance imaging (MRI) |
Cardiac CT |
Stress echocardiogram |
| Magnetic resonance angiograms (MRAs) |
Cardiac MRI |
Stress testing |
| Positron emission tomography (PET) scans |
Diagnostic heart catheterization |
Transesophageal echocardiogram |
| Positron emission tomography – computed tomography (PET-CT) |
Myocardial perfusion imaging (SPECT and PET) |
Transthoracic echocardiogram |
| Computerized tomography (CT) scans |
Nuclear cardiac imaging |
|
| Computed tomography angiography (CTA) scans |
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|
| Nuclear medicine |
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BlueCard program
The BlueCard program is a national program that enables customers of one Blue Plan to obtain healthcare while traveling or living in another Blue plan's service area and includes a nationwide network for processing payment.
Medical policies, pre-certification and pre-authorization requirements, and provider training for out-of-area Blue Plan members are available in our BlueCard Resource Center.