Medicare Prior Authorization Change Summary: Effective 10/1/2025
Date: 09/02/25
A Message for Wellcare Providers. Please share with your team.
Effective October 1, 2025, Wellcare by Allwell is notifying all participating Medicare providers that prior authorization will no longer be required for a series of out-patient, computed tomography (CT) and transthoracic echocardiogram procedure codes.
A comprehensive list of procedure codes affected by this notification are provided in the following table.
Procedure Codes No Longer Requiring Prior Authorization Effective 10/01/2025
| Procedure | Procedure Codes |
|---|---|
| Chest CT | 71250, 71260, 71270, 0722T |
| CT for Low Dose Lung Cancer Screening | 71271 |
| CT of the Pelvis and Abdomen | 74176, 74177, 74178, 0722T |
| Transthoracic Echocardiogram | 93303, 93304, 93306, 93307, 93308, 93320, 93321, 93325, 93356 |
Please Note:
- Non-participating providers require authorization for all HMO services, except where indicated.
- It is the ordering/prescribing provider’s responsibility to determine which specific codes require prior authorization.
- Please verify eligibility and benefits for all members prior to rendering services. Payment, regardless of authorization, is contingent on the member’s eligibility at the time service is rendered.
If you have questions about this bulletin or other provider resources, please contact your Provider Relations Representative or call us at the numbers below:
- Wellcare By Allwell (Medicare Advantage):
- HMO 1-800-977-7522
- D-SNP 1-844-796-6811
- Wellcare Complete 1-800-977-7522
- TTY: 711