Hosted Medical Policy Content

Certain medical policies that support Horizon Prior Authorization and Medical Necessity Determination (PA/MND) programs are “hosted” by the business partner managing the program(s) in question.

Beginning March 6, 2023, the medical policies that support the services included as part of the following programs must be accessed on eviCore’s website:

• Horizon BCBSNJ’s Radiology/Imaging Services program
• Horizon BCBSNJ’s Cardiology Imaging Services program
• Horizon NJ Health’s Radiology and Cardiology programs.

The medical policies listed in the table below can no longer be accessed within our Medical Policy Manual.

To access this medical policy content, please visit eviCore’s Provider’s Hub and access eviCore’s Cardiovascular & Radiology page for Horizon members or for Horizon Medicaid members as appropriate.

Please note that this effort to transition policy content to eviCore’s Provider’s Hub did not involve any changes to the guidelines within the policies listed above. Future changes to this policy content will be communicated via our current processes.