Blue Shield of California

Welcome to the Blue Shield of California Health Plan page. The documents below have been designed to help RadMD users navigate the prior authorization process for each program Evolent is responsible for. Additional process-specific training tools and modules can be found via links on the Resources tab at the top of the screen.
If you have any questions about our programs, please contact your dedicated Evolent Provider Engagement Manager:
- Charles Allison (Advanced Imaging/Cardiology)
- April Fox (Interventional Pain Management/Musculoskeletal)
Effective January 1, 2026 - Medicare and Commercial Providers: Evolent will begin managing select interventional pain management, musculoskeletal surgeries and advanced imaging services for Blue Shield Medicare Advantage PPO plan members. For additional information, please access the Evolent RadMD provider portal at evolent.com/provider-portal, select RadMD. Contact information for your Evolent Provider Engagement Manager can be located within RadMD in the Blue Shield of California section within Provider Resources.
Advanced Imaging Program
- Provider Education Presentation
- Scope of Service
- Utilization Review Matrix - 2025
- Utilization Review Matrix - 2026
For access to our Advanced Imaging tip sheets/checklists, click here.
Musculoskeletal and Interventional Pain Management Program
- Provider Education Presentation
- Scope of Service
- Utilization Review Matrix (Interventional Pain Management) - 2025
- Utilization Review Matrix (Interventional Pain Management) - 2026
- Utilization Review Matrix (Musculoskeletal - Spine Surgery) - 2025
- Utilization Review Matrix (Musculoskeletal - Spine Surgery) - 2026
For access to our Musculoskeletal tip sheets/checklists, click here.
For access to our Interventional Pain Management tip sheets/checklists, click here.
Peer-to-Peer Process
For access to our peer-to-peer process, click here.
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
Clinical Guidelines
- Clinical Guidelines (Advanced Imaging, Interventional Pain Management and Musculoskeletal Spine Surgery Programs)
- Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.
Link to Blue Shield of California Provider Connections Log-in

