Hospital-based high-tech radiology (advanced imaging) coverage
Defines when hospital-based high-tech imaging (MRI, MRA, CT, CTA, PET/PET-CT) is considered medically necessary for non‑Medicare Kaiser Permanente members and what documentation/circumstances justify hospital site of care.
MPC approved the addition of PET scan to the High-End Imaging Site of Care criteria, effective October 1.
Clarified age intent for PET scans related to this policy.
Updated applicable codes to include related HCPCS codes.
Approved modifications to HEI Imaging Site of Care criteria to allow continuity of care for patients already started at higher level of care.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.