Payer PolicyActive
RAD.00061 PET/MRI
ANTHEM-RAD.00061
Anthem
Effective: October 1, 2025
Updated: December 30, 2025
Policy Summary
- Service: Combined positron emission tomography/magnetic resonance imaging (PET/MRI). - Coverage: Anthem considers PET/MRI investigational and not medically necessary for all indications; it is not covered. - Limitations: There are no covered clinical scenarios or exceptions under this policy (including cancer staging or treatment planning); claims may be reported with HCPCS/CPT code 78999.
Coverage Criteria Preview
Key requirements from the full policy
"The use of combined PET/MRI imaging technology is consideredinvestigational and not medically necessaryfor all indications."
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