Which payers have published criteria for CT head without and with contrast (CPT 70470)?

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 CT head without and with contrast (CPT 70470)?

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 CT head without and with contrast (CPT 70470)?

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 CT head without and with contrast (CPT 70470) cost?

Across 1,090 hospitals that publish their negotiated rates, the median commercial insurance rate is $893, with the middle half of rates between $424 and $1,875. A patient's own cost depends on their plan, deductible and where the study is done.

What can be done if CT head without and with contrast (CPT 70470) 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 70470: CT head without and with contrast - Prior Authorization and Price

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CPT 70470

CT imaging of the head or brain done both with and without contrast.

CT 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 Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric and Special Populations Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026	30 that name this code
Anthem BCBS	Carelon	Oncologic imaging effective Apr 4, 2026 Advanced imaging for vascular indications effective Sep 19, 2026 Imaging of the head and neck effective Apr 14, 2024 Imaging of the brain effective Sep 19, 2026	14 that name this code
Cigna	eviCore	Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric and Special Populations Oncology Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026	30 that name this code
Medicare	CMS	NCD 220.1: Computed Tomography effective Mar 12, 2008 L37373: MRI and CT Scans of the Head and Neck (Noridian Healthcare Solutions) effective Oct 23, 2025	2 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	30 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 CT head without and with contrast. Each has its own criteria for when the study is considered appropriate.

CNS and Head Infection/Neuro-COVID-19 Aetna · Cigna · UnitedHealthcare
Headache Aetna · Cigna · UnitedHealthcare
Neurosurgical Imaging Aetna · Cigna · UnitedHealthcare
Pituitary, Sella, Hypothalamus Aetna · Cigna · UnitedHealthcare
Cerebrovascular Disease Aetna · Cigna · UnitedHealthcare
Dizziness, Vertigo and Syncope Aetna · Cigna · UnitedHealthcare
Epilepsy/Seizures Aetna · Cigna · UnitedHealthcare
Head and Facial Trauma Aetna · Cigna · UnitedHealthcare
Mental Health Disorders and Mental Status Change Aetna · Cigna · UnitedHealthcare
Other Imaging Studies Aetna · Cigna · UnitedHealthcare
Scalp and Skull Aetna · Cigna · UnitedHealthcare
Ataxia Aetna · Cigna · UnitedHealthcare
CNS Infection Aetna · Cigna · UnitedHealthcare
Epilepsy and Other Seizure Disorders Aetna · Cigna · UnitedHealthcare
Neuroblastoma Aetna · Cigna · UnitedHealthcare
Non-Small Cell Lung Cancer Aetna · Cigna · UnitedHealthcare
Pediatric Lymphomas Aetna · Cigna · UnitedHealthcare
Pediatric Nasopharyngeal Carcinoma Aetna · Cigna · UnitedHealthcare
Primary Central Nervous System Tumors Aetna · Cigna · UnitedHealthcare
Scalp and Skull Lesions Aetna · Cigna · UnitedHealthcare
Brain and Spinal Cord Malignancy Anthem BCBS
Cancer screening, not otherwise specified Anthem BCBS
Cerebral perfusion imaging Anthem BCBS
Cerebrospinal fluid (CSF) leak of the skull base Anthem BCBS
Colorectal cancer screening Anthem BCBS
Computed Tomography Medicare
Congenital or developmental vascular anomalies, not otherwise specified Anthem BCBS
Head and Neck Cancer Anthem BCBS
Histiocytic Neoplasms Anthem BCBS
MRI and CT Scans of the Head and Neck Medicare
Neuroendocrine Tumors Anthem BCBS
Sinusitis/rhinosinusitis Anthem BCBS
Temporomandibular joint dysfunction Anthem BCBS
Traumatic vascular injury Anthem BCBS
Vasculitis Anthem BCBS
Venous thrombosis or compression, intracranial Anthem BCBS

Typical price

Commercial insurance, median

$893

Middle half of rates: $424 to $1,875

Medicare, hospital outpatient

$179

Facility payment

Medicare, physician fee schedule

$174

National, non-facility

Commercial figures come from negotiated rates published by 1,090 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 CT head without and with contrast change.

CPT 70470: CT head without and with contrast - 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

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CPT 70470: CT head without and with contrast - 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