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New PoliciesEye Prostheses and Scleral Cover Shell05.00.831/24/2025 10:00 AM2/24/20252/24/2025This is a New Policy.
Updated PoliciesExperimental/Investigational Services12.01.01bo1/1/20252/10/2025Coverage and/or Reimbursement Position;Medical Coding
Updated PoliciesTreatment of Obstructive Sleep Apnea (OSA) and Primary Snoring11.00.06u11/19/2024 11:00 AM2/17/20252/17/2025Medical Necessity Criteria
Updated PoliciesLabiaplasty11.06.09e2/24/20252/24/2025Medical Necessity Criteria;Medical Coding
Updated PoliciesBariatric Surgery11.03.02v1/24/2025 11:00 AM2/24/20252/24/2025Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesDenosumab (Prolia®, Xgeva®) and related biosimilars, and Romosozumab-aqqg (Evenity®) 08.00.94t2/24/20252/24/2025Medical Necessity Criteria
Updated PoliciesChimeric Antigen Receptor (CAR) Therapy08.01.43p2/24/20252/24/2025Medical Necessity Criteria
Reissue PoliciesFetal Surgery11.00.03m1/1/20252/5/20252/5/2025
Reissue PoliciesFirst-Trimester Prenatal Screening for Fetal Aneuploidy Using Fetal Ultrasound Markers09.00.36m11/21/20222/19/20252/19/2025
Reissue PoliciesBiofeedback Therapy07.00.01n7/1/20242/19/20252/19/2025
Reissue PoliciesCardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs10.01.01r3/11/20242/19/20252/19/2025
Reissue PoliciesVentricular Assist Devices (VADs)11.02.16u5/29/20232/19/20252/19/2025
Coding UpdateReimbursement for Radiopharmaceutical Agents for Professional Providers09.00.32ah1/1/20252/3/2025
Coding UpdateModifiers 26 (Professional Component) and TC (Technical Component)03.00.20t1/1/20252/7/2025
Coding UpdateModifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service03.00.06ab1/1/20252/7/2025
Coding UpdateLaboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products00.03.07ao1/1/20252/13/2025
Coding UpdateServices Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers00.10.01al1/1/20252/17/2025