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Fidelis Care serves more than 1.7 million children and adults of all ages, making us one of the largest health insurance plans in New York State. We were founded on the belief that all New Yorkers should have access to quality, affordable health insurance, and our mission to help others informs everything that we do. 

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Updated Evolent Authorization Requirements Effective June 1, 2025
2025/5/16 • Posted by Provider Relations in Provider News

The following codes on the Evolent/Fidelis Care authorization grid have been updated effective June 1, 2025.

The following codes have been removed from the Evolent Radiology Cardiology Utilization Review Matrix and no longer require prior authorization for Wellcare by Fidelis Care, Medicaid, Essential Plans, and Ambetter Metal-Level Products:

  • Transthoracic Echocardiogram - 93307, 93303, 93304, 93306, 93307, 93308, 93320, 93321, 93325, 93356
  • Chest CT - 71250, 71260, 71270, 0722T
  • CT for Low Dose Lung Cancer Screening - 71271

 

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