Which payers have published criteria for Low-dose CT chest for lung cancer screening (CPT 71271)?

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 Low-dose CT chest for lung cancer screening (CPT 71271)?

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 Low-dose CT chest for lung cancer screening (CPT 71271)?

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.

What can be done if Low-dose CT chest for lung cancer screening (CPT 71271) 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 71271: Low-dose CT chest for lung cancer screening - Prior Authorization and Price

Home › CPT Codes › Low-dose CT chest for lung cancer screening

CPT 71271

Performing a CT scan of the chest to screen for lung cancer without contrast

CT Chest

Build a submission checklist for this study

Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Chest Imaging Guidelines 1.0.2026, effective Feb 3, 2026	3 that name this code
Anthem BCBS	Carelon	Oncologic imaging effective Apr 4, 2026	46 that name this code
Cigna	eviCore	Chest Imaging Guidelines 1.0.2026, effective Feb 3, 2026	3 that name this code
Medicare	CMS	NCD 220.1: Computed Tomography effective Mar 12, 2008 NCD 210.14: Lung Cancer Screening with Low Dose Computed Tomography (LDCT) effective Feb 10, 2022 L33459: Computerized Axial Tomography (CT), Thorax (Palmetto GBA) effective Jun 11, 2026	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	3 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 Low-dose CT chest for lung cancer screening. Each has its own criteria for when the study is considered appropriate.

Lung Cancer Screening Aetna · Anthem BCBS · Cigna · UnitedHealthcare
Acute Leukemia Anthem BCBS
Anal Cancer Anthem BCBS
Bladder and Urothelial Cancers Anthem BCBS
Bladder/Urothelial Cancers: Muscle Invasive Anthem BCBS
Bladder/Urothelial Cancers: Non-muscle Invasive Anthem BCBS
Bone Sarcoma Anthem BCBS
Brain and Spinal Cord Malignancy Anthem BCBS
Breast Cancer Anthem BCBS
Cancer screening, not otherwise specified Anthem BCBS
Cancers of the Pleura, Thymus, Heart, and Mediastinum Anthem BCBS
Cancers of Unknown Primary / Cancers Not Otherwise Specified Anthem BCBS
Cervical Cancer Anthem BCBS
Chronic lymphocytic leukemia or small lymphocytic lymphoma Anthem BCBS
Colorectal Cancer Anthem BCBS
Colorectal cancer screening Anthem BCBS
Esophageal and Gastroesophageal Junction Cancers Anthem BCBS
Gastric Cancer Anthem BCBS
Gastrointestinal stromal tumor (GIST) Anthem BCBS
Head and Neck Cancer Anthem BCBS
Hepatocellular and Biliary Tract Cancers Anthem BCBS
Hepatocellular carcinoma (HCC) screening Anthem BCBS
Histiocytic Neoplasms Anthem BCBS
Kidney Cancer Anthem BCBS
Lung Cancer – Non-Small Cell Anthem BCBS
Lung Cancer – Small Cell Anthem BCBS
Lymphoma – Hodgkin Anthem BCBS
Lymphoma – Non-Hodgkin Anthem BCBS
Melanoma Anthem BCBS
Merkel Cell Carcinoma Anthem BCBS
Multiple Myeloma Anthem BCBS
Neuroendocrine Tumors Anthem BCBS
Nonseminoma Anthem BCBS
Ovarian Cancer – All Variants Anthem BCBS
Pancreatic Cancer Anthem BCBS
Paraneoplastic Syndrome Anthem BCBS
Penile, Vaginal, and Vulvar Cancers Anthem BCBS
Poorly-differentiated neuroendocrine tumor Anthem BCBS
Prostate Cancer Anthem BCBS
Seminoma Anthem BCBS

Plus 9 more. Use the search below to find a specific condition.

Typical price

Commercial insurance, median

$390

Middle half of rates: $250 to $678

Medicare, hospital outpatient

$107

Facility payment

Medicare, physician fee schedule

$137

National, non-facility

Commercial figures come from negotiated rates published by 934 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 Low-dose CT chest for lung cancer screening change.

CPT 71271: Low-dose CT chest for lung cancer screening - 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

Quick Access - Common Imaging CPT Codes

CT

MRI

MRA

PET

CPT 71271: Low-dose CT chest for lung cancer screening - 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