| Updated Policies | Fertility Preservation (AmeriHealth New Jersey) | 07.10.08g | 12/23/2025 12:00 AM | 1/26/2026 | | | 2/3/2026 | Medical Necessity Criteria | | |
| News & Announcements | Coverage of Meningococcal Groups A, B, C, W, and Y Vaccine (PENMENVY) for Commercial Members (Retroactively Effective 02/14/2025) | | | | | | 2/2/2026 | | | |
| New Policies | Reimbursement For Advanced Practice Provider Services | 00.10.45 | 10/31/2025 2:00 PM | 2/1/2026 | | | 2/1/2026 | This is a New Policy. | | |
| New Policies | Pembrolizumab and berahyaluronidase alfa-pmph (Keytruda QLEX™) | 08.02.49 | | 2/2/2026 | | | 2/3/2026 | This is a New Policy. | | |
| New Policies | Chimeric Antigen Receptor Therapy (CART): Carvykti® & Abecma® | 08.02.50 | | 2/9/2026 | | | 2/9/2026 | This is a New Policy. | | |
| Updated Policies | Reimbursement for Components of Comprehensive Laboratory Panels | 00.01.61b | 10/31/2025 2:00 PM | 2/1/2026 | | | 2/3/2026 | Coverage and/or Reimbursement Position;Medical Coding | | |
| Updated Policies | Chimeric Antigen Receptor (CART) Therapy: Yescarta Tecartus, Breyanzi, Kymriah and Aucatzyl | 08.01.43q | | 2/9/2026 | | | 2/9/2026 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Experimental/Investigational Services | 12.01.01bs | | 1/1/2026 | | | 2/9/2026 | Medical Coding | | |
| Updated Policies | eviCore Lab Management (AmeriHealth) | 06.02.52am | | 1/1/2026 | | | 2/23/2026 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Coding Update | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | 00.01.25bu | | 1/1/2026 | | | 2/1/2026 | | | |
| Coding Update | Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers | 00.10.01am | | 1/1/2026 | | | 2/3/2026 | | | |
| Coding Update | Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products | 00.03.07ar | | 1/1/2026 | | | 2/3/2026 | | | |
| Coding Update | Reimbursement for Radiopharmaceutical Agents | 09.00.32al | | 1/1/2026 | | | 2/3/2026 | | | |
| Coding Update | Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®) | 08.01.80e | | 1/1/2026 | | | 2/11/2026 | | 2/10/2026 | 2/11/2026 |
| Coding Update | Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®) | 08.01.80e | | 1/1/2026 | | | 2/16/2026 | | | |