Site of Care: High-tech Radiology - (0550)

Cigna covers hospital-based MRI/MRA/CT/CTA only when one of the listed indications is met (age ≤18, obstetrical/perinatology care, transplant-related imaging at an approved center, planned use of a contrast agent in a patient with known contrast allergy, emergent/urgent need, or when no appropriate freestanding alternative exists for specified reasons such as pre-op imaging integral to a hospital procedure, required moderate/deep sedation or anesthesia, size-specific equipment, claustrophobia needing open MRI, or need to match prior hospital studies); all other hospital-based high‑tech imaging is considered not medically necessary. Documentation of the specific indication (and lack of an alternative site when claimed), appropriate diagnosis/procedure codes, and compliance with applicable Cigna‑eviCore pre‑certification and medical‑necessity criteria are required (policy does not apply if no freestanding facility exists locally or using one would cause a health disparity).