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Advanced Imaging and Cardiology Services Program

Highmark has partnered with eviCore healthcare (eviCore) for the Advanced Imaging and Cardiology Services Program. This program incorporates a comprehensive, evidence-based clinical review including predictive intelligence, clinical decision support, and peer-to-peer discussions.

eviCore will manage the prior authorizations for advanced imaging and cardiology services for Highmark's fully insured Commercial and Affordable Care Act (ACA) members, plus members of select self-insured (Administrative Services Only) groups.

Effective August 1, 2021, the program will expand to include out-of-area (OOA) and out-of-network (OON) cardiology and radiology services.

Note: The Federal Employee Program is excluded from this program.

Learn More About the Advanced Imaging and Cardiology Services Program

eviCore has a dedicated webpage for Highmark providers to conveniently access evidence-based clinical guidelines, the current CPT code list, important resources and recent announcements. We encourage you to visit their site to ensure that you have the most current information.

Reference Materials

In addition to this site and the eviCore webpage, you can also find any updates about the Advanced Imaging and Cardiology Services Program in the online provider portal(s) and future issues of Provider News.

Last updated on 10/26/2023 11:03:04 AM

 

eviCore healthcare is an independent company that does not provide Highmark products or services and is solely responsible for the products and services described here.
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Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.