CommunityCare Oklahoma

Welcome to the CommunityCare Oklahoma 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:
- Betsy Roberts (Advanced Imaging/Cardiology)
- Sharee Adams (Interventional Pain Management/Musculoskeletal/Physical Medicine)
Program Update: Effective March 1, 2026, CommunityCare of Oklahoma Advanced Imaging and Diagnostic Cardiology authorization requests will include updated questions around site of service selection when determining the rendering provider for the imaging procedure. When a request is submitted with a hospital as the selected setting, providers will be prompted to provide clinical justification for using the hospital setting or select a non-hospital imaging facility. For questions, please contact your Provider Engagement Manager or email [email protected].
Advanced Imaging and Cardiology Program
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix - Commercial - 2025
- Utilization Review Matrix - Medicare - 2025
- Utilization Review Matrix - Commercial - 2026
- Utilization Review Matrix - Medicare - 2026
For access to our Advanced Imaging tip sheets/checklists, click here.
Musculoskeletal Surgery and Interventional Pain Management Program
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix (IPM) - 2025
- Utilization Review Matrix (MSK - Hip, Knee and Shoulder) - 2025
- Utilization Review Matrix (MSK - Spine Surgery) - 2025
- Utilization Review Matrix (IPM) - 2026
- Utilization Review Matrix (MSK - Hip, Knee and Shoulder) - 2026
- Utilization Review Matrix (MSK - Spine Surgery) - 2026
For access to our Musculoskeletal Surgery tip sheets/checklists, click here.
For access to our Interventional Pain Management tip sheets/checklists, click here.
Physical Medicine Program
For access to our Physical Medicine 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 Site of Care Guidelines
- Evolent Place of Service Policy for Advanced Imaging
- Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.

