Which payers have published criteria for MRI jaw joint (TMJ) (CPT 70336)?

The imaging guidelines used by Aetna, Anthem BCBS, Cigna, Medicare, UnitedHealthcare include criteria that apply to this study. Whether a specific patient's plan requires prior authorization depends on the plan, so confirm on the payer's portal or by phone before scheduling.

Who reviews prior authorization requests for MRI jaw joint (TMJ) (CPT 70336)?

Most commercial payers hand imaging reviews to a radiology benefit manager. For the payers tracked here, requests are reviewed using guidelines from eviCore, Carelon, CMS, UnitedHealthcare / eviCore. The request is submitted through that organization's portal rather than the health plan's general line.

What should be in the clinical notes before requesting MRI jaw joint (TMJ) (CPT 70336)?

Reviewers look for a recent office visit that documents the symptoms and how long they have lasted, exam findings, results of any earlier imaging, treatments already tried and how the patient responded, and the specific question the study is expected to answer. The diagnosis code on the request should match what the notes describe.

How much does MRI jaw joint (TMJ) (CPT 70336) cost?

Across 956 hospitals that publish their negotiated rates, the median commercial insurance rate is $1,070, with the middle half of rates between $510 and $2,039. A patient's own cost depends on their plan, deductible and where the study is done.

What can be done if MRI jaw joint (TMJ) (CPT 70336) is denied?

Read the denial letter for the stated reason, then request a peer-to-peer conversation between the ordering clinician and the reviewing physician, which often resolves missing-information denials. If that fails, file a written appeal that answers the stated reason directly and attach the supporting notes. The denial letter lists the deadline and where to send the appeal.

CPT 70336: MRI jaw joint (TMJ) - Prior Authorization and Price

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CPT 70336

Performing an MRI of the jaw joint.

MRI Head & Neck

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Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Musculoskeletal Imaging Guidelines 2.0.2026, effective Sep 1, 2026	4 that name this code
Anthem BCBS	Carelon	Imaging of the head and neck effective Apr 14, 2024	1 that name this code
Cigna	eviCore	Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Musculoskeletal Imaging Guidelines 2.0.2026, effective Sep 1, 2026	4 that name this code
Medicare	CMS	NCD 220.2: Magnetic Resonance Imaging effective Apr 10, 2018 L37373: MRI and CT Scans of the Head and Neck (Noridian Healthcare Solutions) effective Oct 23, 2025 L34425: Magnetic Resonance Imaging of the Head and Neck (Palmetto GBA) effective Mar 27, 2025	3 that name this code
Original Medicare does not run a prior authorization program for outpatient imaging; claims are judged against the coverage policies above. Medicare Advantage plans set their own prior authorization rules.
UnitedHealthcare	UnitedHealthcare / eviCore	Commercial and Exchange Cardiovascular and Radiology Imaging Guidelines 09.2026, effective Sep 1, 2026	4 that name this code

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss MRI jaw joint (TMJ). Each has its own criteria for when the study is considered appropriate.

Temporomandibular Joint Disease (TMJ) and Dental/Periodontal/Maxillofacial Imaging Aetna · Cigna · UnitedHealthcare
Inflammatory Musculoskeletal Disease Aetna · Cigna · UnitedHealthcare
Temporomandibular Joint (TMJ)/Dental/Maxillofacial Imaging in Children Aetna · Cigna · UnitedHealthcare
Magnetic Resonance Imaging Medicare
Magnetic Resonance Imaging of the Head and Neck Medicare
MRI and CT Scans of the Head and Neck Medicare
Temporomandibular joint dysfunction Anthem BCBS

Typical price

Commercial insurance, median

$1,070

Middle half of rates: $510 to $2,039

Medicare, hospital outpatient

$244

Facility payment

Medicare, physician fee schedule

$261

National, non-facility

Commercial figures come from negotiated rates published by 956 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.

Get notified when the rules for this study change

Payers update imaging guidelines several times a year. We will email you when the criteria for MRI jaw joint (TMJ) change.

CPT 70336: MRI jaw joint (TMJ) - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

Frequently asked questions

Imaging CPT Code Coverage Lookup

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CPT 70336: MRI jaw joint (TMJ) - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

Frequently asked questions

Related studies

Imaging CPT Code Coverage Lookup

Quick Access - Common Imaging CPT Codes

CT

MRI

MRA

PET