Radiology Prior Authorization Program Summary

Prior Authorization will be required for all outpatient MR, CT and PET imaging studies for all Rhode Island Medical Assistance plan participants starting January 01, 2008. Please note that prior authorization is not required for Nuclear Cardiology.

Evicore will administer prior authorizations through 9/25/2026.  Contact Evicore toll-free, 8am-9pm ET at 888-693-3211 if you have any questions.

Evicore Decommission

Effective October 1, 2026, RI Medicaid will utilize IPRO, one of the nation’s most experienced healthcare quality improvement organizations, working with state and federal governments, providers, consumers, and communities across the United States to help ensure that healthcare is safe, accessible, and equitable across all settings and payers for Radiology Prior Authorizations.  Requests for authorizations for date of services 10/1/2026 forward should be faxed to IPRO.  To contact IPRO:

• Phone: Main (800) 624-2554 
•  Fax: (800) 446-2447 

RI Medicaid will receive authorization data from IPRO daily.  Providers can view the status of an authorization on RI Medicaid’s Healthcare Portal.

Evicore will no longer accept “new” requests as of 9/25/2026 and IPRO will begin accepting “new" requests as of 9/28/2026.