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Cardiology Procedures: Transition of Utilization Review from TurningPoint to Evolent Effective for Service Dates beginning July 1, 2025

Date: 04/01/25

Effective July 1, 2025, Utilization Review of cardiology services and procedures will transition from TurningPoint Healthcare Solutions, LLC, Texas URA #2395464, to Evolent Specialty Services, Inc., Texas URA #1777359.

Effective for service dates July 1, 2025, and after, prior authorization must be requested through Evolent for applicable non-emergent, cardiology services.  

This transition applies to Superior HealthPlan Medicaid (STAR, STAR Health, STAR+PLUS) members aged 21 and older, and Ambetter from Superior HealthPlan members aged 18 and older.

The procedure codes that require prior authorization for cardiology services and procedures, along with the prior authorization prescreen tools, can be found on Superior’s Authorization Requirements webpage. To review specific changes to prior authorization requirements, view Superior’s Effective July 1, 2025: Changes to Prior Authorization Requirements for Cardiology Services and Procedures web post.

Key Provisions

  • The ordering physician is responsible for obtaining authorization prior to performing procedures and services.
  • Providers may begin contacting Evolent on June 24, 2025, to request prior authorization for procedures scheduled for dates of service on or after July 1, 2025.
  • Prior authorization requests for dates of service prior to July 1, 2025, must continue to be requested through TurningPoint.
  • Interventional cardiology services will require prior authorization through Evolent prior to being rendered in a provider office, outpatient hospital, ambulatory, or inpatient setting (planned professional services only).
  • Prior authorization will not be required when emergent.

Introductory (informational) and in-service training sessions are scheduled for several dates beginning in June. For more details and information on registration, please visit the Evolent webpage. If you have questions about Evolent, please email providertraining@evolent.com.  

Additional Information

Updates will be available through:

For questions related to Superior, please contact your assigned Superior Provider Representative. To access their information, visit the Find My Provider Representative webpage.