Fallon Provider Resources
Please download and read through the following material. Our goal is to make the change to EviCore as seamless and easy as possible and these documents will explain the process. There is contact information in the material if you have any questions.
Effective 06/01/26 – prior authorization is no longer required for CT Scans and MRI of Brain, for In-Network providers and facilities only. Out-of-Network providers and facilities still require prior authorization for CT Scans and MRI of the Brain. Out-of-Network requests for one of the CPT Codes below should be submitted directly to Fallon Health. Phone: 1-844-224-0490 and Fax: 1-800-540-2406.
CT Scan: 70450, 70460, 70470, 70471, 70472, 70473, 70480,70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 70496, 70498, 71250, 71260, 71270, 71271, 71275, 72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72191, 72192, 72193, 72194, 73200, 73201, 73202, 73206, 73700, 73701, 73702, 73706, 74150, 74160, 74170, 74174, 74175, 74176, 74177, 74178, 74261, 74262, 75571, 75572, 75573, 75574, 75635, 76380, 76497, 77011, 77012, 77013, 77078, 0633T, 0634T, 0635T, 0636T, 0637T, 0638T.
MRI of the Brain: 70551, 70552, 70553, 70554, 70555, 0865T, 0866T.
Effective 02/01/2026, the management of Fallon Health prior authorizations through EviCore will transition from the MedSolutions portal platform to the CareCore National portal platform. The User ID and Password will remain the same.
Cardiovascular
Radiology
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Registration Instructions
EviCore highly recommends providers take full advantage of the online capabilities at https://www.evicore.com/provider
Here you can request prior authorization, review our nationally accepted evidence-based guidelines, and receive announcements about program updates. Access requires only your email address and a brief registration.