| News & Announcements | Coverage of the COVID-19 Vaccination for AmeriHealth Members (Updated on June 19, 2023) | | | | | | 6/19/2023 | | | |
| News & Announcements | 7/01/2023 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | | | | | | 6/30/2023 | | | |
| Notifications | eviCore Lab Management (AmeriHealth) | 06.02.52ac | 6/1/2023 10:00 AM | 7/1/2023 | | | 6/1/2023 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Notifications | Modifier 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 Service | 03.00.06x | 6/15/2023 2:00 PM | 10/2/2023 | | | 6/15/2023 | Coverage and/or Reimbursement Position;Medical Coding | | 6/15/2023 |
| Notifications | Modifier 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 Service | 03.00.06x | 6/19/2023 2:00 PM | 10/2/2023 | | | 6/19/2023 | Coverage and/or Reimbursement Position;Medical Coding | | |
| Notifications | Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists, VEGF Biosimilars, and combination VEGF/Angiopoietin-2 (Ang-2) inhibitors | 08.00.74s | 6/20/2023 9:00 AM | 9/18/2023 | | | 6/20/2023 | Medical Necessity Criteria | | |
| New Policies | Retifanlimab-dlwr (Zynyz TM) | 08.02.05 | | 6/5/2023 | | | 6/5/2023 | This is a New Policy. | | |
| Updated Policies | Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease | 08.01.93a | | 6/5/2023 | | | 6/5/2023 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Self-Administered Drugs | 08.00.78am | | 6/5/2023 | | | 6/5/2023 | Coverage and/or Reimbursement Position;Medical Coding | | |
| Updated Policies | Removal of Breast Implants | 11.08.14n | | 6/5/2023 | | | 6/5/2023 | Coverage and/or Reimbursement Position;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | patisiran (Onpattro®) and vutrisiran (Amvuttra™) | 08.01.50c | 3/14/2023 10:00 AM | 6/12/2023 | | | 6/12/2023 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Asparaginase Erwinia Chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze®) | 08.01.35g | | 6/19/2023 | | | 6/19/2023 | Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Tafasitamab-cxix (Monjuvi®) | 08.01.81b | | 6/19/2023 | | | 6/19/2023 | Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Margetuximab-cmkb (Margenza) | 08.01.75c | | 6/19/2023 | | | 6/19/2023 | Medical Necessity Criteria | | |
| Updated Policies | Ostomy Supplies | 05.00.50o | | 6/30/2023 | | | 6/30/2023 | Coverage and/or Reimbursement Position;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Injectable Dermal Fillers for Cosmetic Procedures | 05.00.62i | 3/31/2023 1:00 PM | 7/1/2023 | | | 6/30/2023 | General Description, Guidelines, or Informational Update | | |
| Updated Policies | Preventive Care Services | 00.06.02am | | 7/1/2023 | | | 6/30/2023 | Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Reimbursement for the Administration of Drugs, Substances, and/or Biologic Agents | 00.10.43d | | 7/1/2023 | | | 6/30/2023 | Medical Coding | | |
| Reissue Policies | Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis | 11.15.22d | | 1/1/2017 | 5/31/2023 | | 6/1/2023 | | | |
| Reissue Policies | Anifrolumab-fnia (Saphnelo®) | 08.01.82b | | 4/1/2022 | 6/2/2023 | | 6/2/2023 | | | |
| Reissue Policies | Dofetilide (Tikosyn®) Use in the Inpatient Setting | 08.00.49e | | 9/26/2019 | 6/2/2023 | | 6/2/2023 | | | |
| Reissue Policies | Home-Based Sleep Studies | 07.03.01b | | 10/1/2022 | 6/14/2023 | | 6/14/2023 | | | |
| Reissue Policies | Air Ambulance Services | 12.04.03c | | 1/1/2019 | 6/14/2023 | | 6/14/2023 | | | |
| Reissue Policies | Personalized Vaccines (e.g., Provenge®) | 08.00.95f | | 12/20/2021 | 6/14/2023 | | 6/14/2023 | | | |
| Reissue Policies | Spesolimab--sbzo (Spevigo®) | 08.01.97a | | 4/1/2023 | 6/14/2023 | | 6/15/2023 | | | |
| Reissue Policies | Photodynamic Therapy (PDT) Using Verteporfin (Visudyne®) | 07.13.05k | | 5/7/2018 | 6/14/2023 | | 6/15/2023 | | | |
| Reissue Policies | Intravenous (IV) Administration of Fluids as a Treatment of a Medical Condition or for the Preparation of Pharmaceuticals, Biologics, and other Substances | 00.01.45 | | 1/8/2010 | 6/14/2023 | | 6/15/2023 | | | |
| Reissue Policies | Inebilizumab-cdon (Uplizna) | 08.01.68b | | 8/9/2021 | 6/14/2023 | | 6/15/2023 | | | |
| Reissue Policies | Skilled Nursing Facility (SNF): Skilled and Subacute Levels of Care | 02.03.00 | | 11/1/2020 | 6/14/2023 | | 6/15/2023 | | | |
| Reissue Policies | Automatic External Cardioverter Defibrillators (Wearable and Nonwearable) | 05.00.29n | | 11/21/2022 | 6/14/2023 | | 6/15/2023 | | | |
| Reissue Policies | Colorectal Cancer Screening | 11.03.12t | | 7/1/2021 | 6/14/2023 | | 6/15/2023 | | | |
| Reissue Policies | Photodynamic Therapy (PDT) Using Levulan® Kerastick® or Ameluz® (Aminolevulinic Acid HCl [ALA]) | 07.07.03m | | 7/1/2019 | 6/14/2023 | | 6/15/2023 | | | |
| Reissue Policies | Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound (AmeriHealth) | 11.02.27g | | 1/1/2023 | 6/28/2023 | | 6/28/2023 | | | |
| Reissue Policies | Orthoptic/Pleoptic Training | 07.13.01j | | 1/1/2023 | 6/28/2023 | | 6/28/2023 | | | |
| Reissue Policies | Implantation of Intrastromal Corneal Ring Segments (ICRS) | 11.05.11c | | 9/7/2016 | 6/28/2023 | | 6/28/2023 | | | |
| Reissue Policies | Endovascular Grafts for Abdominal Aortic Aneurysms (AAA), Aorto-Iliac Aneurysms, and Infrarenal Aortic Aneurysms | 11.02.10p | | 1/1/2022 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Outpatient Physical Medicine, Rehabilitation, and Habilitation Services | 10.03.01n | | 8/29/2022 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Uterine Artery Embolization | 11.06.04k | | 5/20/2019 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Speech Therapy | 10.06.01l | | 1/1/2020 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Electrical Bone Growth Stimulation and Low-Intensity Ultrasound Accelerated Fracture Healing System (Amerihealth Administrators) | 05.00.09i | | 1/10/2021 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Sentinel Lymph Node Biopsy and Mapping | 11.07.02k | | 1/1/2023 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Parenterally Administered Terbutaline Sulfate for the Prevention or Treatment of Pre-Term Labor | 07.10.04c | | 2/22/2017 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Intra-Articular Injection of Hyaluronan for the Treatment of Osteoarthritis | 11.14.07x | | 4/1/2021 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Laparoscopic, Percutaneous, and Transcervical Techniques for Uterine Fibroid Myolysis | 11.06.10 | | 6/6/2022 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Prophylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and Hysterectomy | 11.08.19p | | 10/1/2022 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Endometrial Ablation | 11.06.05f | | 5/20/2019 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Radium Ra 223 dichloride (Xofigo®) Injection (AmeriHealth Administrators) | 08.01.14e | | 3/1/2019 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Proton Beam Radiation Therapy | 09.00.49m | | 7/5/2022 | 6/28/2023 | | 6/29/2023 | | | |
| Reissue Policies | Complete Decongestive Therapy (CDT) | 07.06.01b | | 12/30/2013 | 6/28/2023 | | 6/29/2023 | | | |
| Coding Update | Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments | 06.02.44q | | 7/1/2023 | | | 6/30/2023 | | | |
| Coding Update | Coagulation Factors | 08.00.92af | | 7/1/2023 | | | 6/30/2023 | | | |
| Coding Update | Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG) | 08.00.13af | | 7/1/2023 | | | 6/30/2023 | | | |
| Coding Update | Self-Administered Drugs | 08.00.78an | | 7/1/2023 | | | 6/30/2023 | | | |
| Coding Update | Coverage of Anticancer Prescription Oral and Injectable Drugs and Biologics and Supportive Agents | 08.01.08m | | 7/1/2023 | | | 6/30/2023 | | | |
| Coding Update | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | 11.08.20ag | | 7/1/2023 | | | 6/30/2023 | | | |
| Coding Update | Insertion of Implantable Infusion Pumps | 11.15.03n | | 7/1/2023 | | | 6/30/2023 | | | |
| Coding Update | Mosunetuzumab-axgb (Lunsumio™) | 08.02.00a | | 7/1/2023 | | | 6/30/2023 | | | |
| Coding Update | Ublituximab-xiiy (Briumvi TM) for intravenous use | 08.02.02a | | 7/1/2023 | | | 6/30/2023 | | | |
| Coding Update | Mirvetuximab soravtansine-gynx (Elahere TM) | 08.02.01a | | 7/1/2023 | | | 6/30/2023 | | | |
| Archived Policies | Lysis of Epidural Adhesions | 11.15.13d | 6/30/2023 12:00 PM | 7/31/2023 | | | 6/30/2023 | | | |
