New Routine Test Management Program Begins Early 2026

Premera is introducing a new Routine Test Management (RTM) program starting early 2026 through a company called Avalon Healthcare Solutions. This new program helps members receive high quality services at the most affordable cost.

The program includes laboratory policies based on the latest science and clinically accepted, peer-reviewed laboratory services guidelines.

What you need to know

• New and revised policies that impact certain laboratory services, tests, and procedures will be published later this year.

• Consistent enforcement of laboratory policies will occur through an automated claim editing for selected laboratory tests performed in office, hospital outpatient and independent laboratory locations.

• Laboratory services, tests, and procedures provided in the emergency room, hospital observation, and hospital inpatient settings are excluded from this program.

We appreciate your patience as we make this important transition. Stay tuned for more updates in Provider News.