Which payers have published criteria for Coronary CT angiography (CPT 75574)?

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 Coronary CT angiography (CPT 75574)?

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 Coronary CT angiography (CPT 75574)?

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 Coronary CT angiography (CPT 75574) cost?

Across 872 hospitals that publish their negotiated rates, the median commercial insurance rate is $841, with the middle half of rates between $432 and $1,748. A patient's own cost depends on their plan, deductible and where the study is done.

What can be done if Coronary CT angiography (CPT 75574) 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 75574: Coronary CT angiography - Prior Authorization and Price

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CPT 75574

CT angiography of the heart's blood vessels and grafts using contrast.

CTA Heart

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Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Cardiac Imaging Guidelines effective Feb 3, 2026 Abdomen Imaging Guidelines 1.0.2026, effective Feb 3, 2026	13 that name this code
Anthem BCBS	Carelon	Imaging of the heart effective Nov 15, 2025	4 that name this code
Cigna	eviCore	Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Cardiac Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Abdomen Imaging Guidelines 1.0.2026, effective Feb 3, 2026	13 that name this code
Medicare	CMS	NCD 220.1: Computed Tomography effective Mar 12, 2008 L33559: Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) (Wellpoint Federal) effective Apr 1, 2026 L33947: Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) (CGS Administrators) effective Oct 9, 2025 L35121: Coronary Computed Tomography Angiography (CCTA) (WPS Insurance Corporation) effective Oct 30, 2025	5 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	13 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 Coronary CT angiography. Each has its own criteria for when the study is considered appropriate.

Congestive Heart Failure Aetna · Cigna · UnitedHealthcare
Kawasaki Disease Aetna · Cigna · UnitedHealthcare
Transplant Aetna · Cigna · UnitedHealthcare
Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) Medicare
Cardiac Computed Tomography & Angiography (CCTA) Medicare
Computed Tomography Medicare
Coronary Computed Tomography Angiography (CCTA) Medicare
Established flow-limiting CAD in patients who have new or worsening symptoms Anthem BCBS
Established or suspected CAD Anthem BCBS
Miscellaneous indications for CCTA Anthem BCBS
Suspected CAD in symptomatic patients who have not had evaluation for CAD within the preceding 60 days Anthem BCBS

Typical price

Commercial insurance, median

$841

Middle half of rates: $432 to $1,748

Medicare, hospital outpatient

$356

Facility payment

Medicare, physician fee schedule

$327

National, non-facility

Commercial figures come from negotiated rates published by 872 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 Coronary CT angiography change.

CPT 75574: Coronary CT angiography - 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 75574: Coronary CT angiography - 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