Big Sky Imaging clinic in Great Falls, Montana

For Patients

Do You Need a Referral for Imaging in Montana?

Big Sky Imaging · September 3, 2026

Short answer: yes, you need an order from a provider. But that is almost never the thing standing between you and your scan. The delay people actually run into is insurance prior authorization, and that is a different animal. It is worth understanding the difference, because one of them takes a phone call and the other can take weeks.

An order and an authorization are not the same thing

A provider's order is a clinician saying which study you need and why. Diagnostic imaging requires one everywhere, not just here. It is what tells the technologist what to capture, and it is what the radiologist reads against when interpreting your images. Without it there is no clinical question to answer.

A prior authorization is your insurance company agreeing in advance to pay. That is the step that generates the paperwork, the callbacks, and the multi-week wait. Big Sky does not require an insurance authorization to schedule you. If you are paying cash, insurance is not in the picture at all.

So when people search for imaging "without a referral," what they usually mean is "without the wait." That part we can help with.

If you do not have an order yet

More people can write one than most patients realize:

Your primary care provider, including direct primary care clinics
An urgent care clinic
A specialist you are already seeing
A physical therapist. Montana PTs can refer for imaging, which surprises a lot of patients and a fair number of clinicians

If you are not sure who to ask, call us at (855) 249-9729 and we will talk through it. We cannot write the order ourselves, but we can tell you exactly what to ask for so you are not making a second appointment to fix a vague one.

What "fast" actually looks like

We offer four things: X-ray, ultrasound, echocardiograms and EKGs. Same-day is the standard for X-ray and EKG in covered markets. Ultrasound and echocardiograms are scheduled quickly rather than same-day.

Results move quickly too. Our teleradiology partner, Rapid Radiology, returns most X-ray reads the same day, and echocardiogram reads are typically back within 24 hours.

Availability is not identical in every market, and we would rather tell you that plainly than have you drive somewhere for a study we do not perform there. Our locations page lists what each hub offers, or you can call and we will check in about ten seconds.

You do not have to come to us

This is the part that changes the math for a lot of people in Montana. We are mobile. A technologist can come to a home, a clinic, a skilled nursing or assisted living facility, a rural clinic, or a correctional facility. If travel is the obstacle, whether that is ninety miles of highway, a wheelchair, or a January storm, the study can come to the patient instead.

Patients who can travel are welcome at our clinics. Both routes need the same thing: an order.

Paying without insurance

Cash pay is accepted and straightforward, which matters for self-pay and rural patients. Medicare and Medicaid are accepted as well. Because we do not need an authorization to schedule, your care is not sitting in a queue waiting on someone else's paperwork.

For what drives imaging costs generally, and why the same scan can carry very different prices depending on where it is done, see what imaging costs in Montana and the same scan at three prices.

What we do not do

We do not perform MRI, CT, mammography or DEXA. If your order calls for one of those, we are not your stop, and we would rather say so on this page than waste your afternoon. Here is the full list and where those studies generally happen in Montana.

It is worth asking your provider whether the question can be answered with something we do offer. Plenty of clinical questions that people assume need an MRI are answered by an X-ray or an ultrasound, sooner and for less.

Common questions

Can I get an echocardiogram without a referral?

You still need a provider's order for the echocardiogram itself, but you do not need insurance prior authorization to get on our schedule. If you do not have an order, your PCP, a specialist, or an urgent care clinic can write one. Call (855) 249-9729 and we will tell you what to ask for.

Can I refer myself for imaging?

No. Diagnostic imaging requires a clinician's order, which is a clinical and billing requirement rather than a Big Sky policy. The fastest route is usually a same-week appointment with a primary care or urgent care clinic, and in Montana a physical therapist can also refer for imaging.

How quickly can I get an X-ray?

Same-day is the standard for X-ray in covered markets, either in one of our clinics or with a technologist coming to the patient. Once we have the order we can usually tell you the soonest slot on the same call.

Do I need insurance?

No. Cash pay is accepted, and so are Medicare and Medicaid. We do not require an insurance authorization to schedule, so being uninsured or self-pay does not put you at the back of a queue.

Do you offer MRI or CT?

No. We offer X-ray, ultrasound, echocardiograms and EKGs. We do not perform MRI, CT, mammography or DEXA. If your order calls for one of those, ask your provider where they would send you, or read the scans we do not offer.

Can you come to a nursing home or assisted living facility?

Yes. On-site imaging at skilled nursing and assisted living facilities is a large part of what we do, and it avoids the cost and risk of transferring a resident out for a study. See mobile imaging for care facilities.

The short version

You need an order. You do not need an insurance authorization, and you do not need to travel if travel is the hard part. If you have an order in hand, send it through our referral form, fax it to (406) 206-5015, or call (855) 249-9729. If you do not have one yet, call anyway and we will point you at the shortest path to getting one.