amerihealth
Advanced Search
MPIssuedDate
  
MPNewsFlashTopicPub
MPNFSortOrder
  
MPPolicyPageName
  
MPPurposePub
Title
  
MPPageName
  
1/16/2026
Coverage of Immune Globulin Intravenous (IVIG) and Subcutaneous (SCIG) for Measles Post-Exposure Prophylaxis in Medicare Advantage Members
0.1
The purpose of this document is to communicate the Company's coverage position for immune globulin intravenous (IVIG) and subcutaneous (SCIG) for measles post-exposure prophylaxis in Medicare Advantage members.​
Coverage of Immune Globulin Intravenous (IVIG) and Subcutaneous (SCIG) for Measles Post-Exposure Prophylaxis in Medicare Advantage Members1fc9d29c-2d9e-4ef8-9781-7dbaf55f4cce
12/31/2025
01/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products
0.1
The intent of this document is to communicate the Company's Medicare Advantage coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 01/01/2026.

For more information related to these services, please refer to specific policies when applicable​.​​

01/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products31530a99-a032-432b-a870-b5e5159e2d45
10/6/2025
Coverage of mNEXSPIKE (COVID-19 Vaccine, mRNA) for Medicare Advantage Members (Retroactively effective to August 27, 2025)
0.1

Retroactively effective to August 27, 2025,​ the purpose of this communication is to provide notice of updates to coverage of COVID-19 Vaccine, mRNA (mNEXSPIKE).​

Coverage of mNEXSPIKE (COVID-19 Vaccine, mRNA) for Medicare Advantage Members (Retroactively effective to August 27, 2025)5950a72f-9e35-47b9-b95c-be4f100e0b11
10/1/2025
10/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products
0.1
The intent of this document is to communicate the Company's Medicare Advantage coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 10/01/2025.

For more information related to these services, please refer to specific policies when applicable​.​

10/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products951a6617-3fc7-48bc-85d7-357e87a70d92
9/8/2025
New Preventive Coverage of Lenacapavir (Yeztugo) for Pre-exposure Prophylaxis (PrEP) for the Prevention of HIV Infection for Medicare Advantage members (Retroactively Effective to June 18, 2025)
0.1
The purpose of this communication is to provide notice regarding the new preventive coverage of lenacapavir (Yeztugo) for pre-exposure prophylaxis (PrEP) for the prevention of HIV infection for Medicare Advantage members (retroactively effective to June 18, 2025)​.​
New Preventive Coverage of Lenacapavir (Yeztugo) for Pre-exposure Prophylaxis (PrEP) for the Prevention of HIV Infection for Medicare Advantage members (Retroactively Effective to June 18, 2025)8bc91fc6-09a7-49f5-9e81-5caa37241645
7/1/2025
07/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products
1
The intent of this document is to communicate the Company's Medicare Advantage coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 07/01/2025.

For more information related to these services, please refer to specific policies when applicable​.​​​​​​​​

07/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products7de8507c-3557-4a74-94d8-ec10a2d70ae4
6/6/2025
Updated Preventive Coverage for Colorectal Cancer Screening and Ultrasound Abdominal Aortic Aneurysm (AAA) Screening for Medicare Advantage members (Retroactively Effective)
0.1

​In accordance with CMS, this communication provides notice of updated preventive coverage for Medicare Advantage members for the following services: 


  • Retroactively effective to October 3, 2024, CMS ​updated the colorectal screening coverage to add Cologuard Plus™ as a preventive service.  ​​​

  • Retroactively effective to April 1, 2025, CMS updated the colorectal cancer screening coverage to add Shield™​ as a preventive service.​

  • Retroactively effective to April 1, 2025​, CMS updated the diagnosis codes (Z84.89 OR Z13.6 with any of the following Z87.891, F17.210, F17.211, F17.213, F17.218, F17.219) for Ultrasound Abdominal Aortic Aneurysm (AAA) Screening for Medicare Advantage members. ​



Updated Preventive Coverage for Colorectal Cancer Screening and Ultrasound Abdominal Aortic Aneurysm (AAA) Screening for Medicare Advantage members (Retroactively Effective)c99bb594-a7bc-46b3-b9fb-1931ff7799db
5/22/2025
The Aurora Extravascular Implantable Cardioverter Defibrillator (EV-ICD) System (Medtronic Inc.) for the treatment of life-threatening ventricular arrhythmias (Retroactively Effective To October 20, 2023)
0.1
This communication is being issued to provide advance notice of the updated coverage position for the Aurora Extravascular Implantable Cardioverter Defibrillator (EV-ICD) System (Medtronic Inc.) for the treatment of life-threatening ventricular arrhythmias for Medicare Advantage members.
The Aurora Extravascular Implantable Cardioverter Defibrillator (EV-ICD) System (Medtronic Inc.) for the treatment of life-threatening ventricular arrhythmias (Retroactively Effective To October 20, 2023)e44639e1-dccf-43ee-9c8f-18fd3ebb2dff
4/29/2025
Updated Preventive Coverage for Hepatitis B Vaccine and Colorectal Cancer Screening (Retroactively Effective)
0.1

The purpose of this communication is: 

  • to provide notice of updated preventive coverage for hepatitis B vaccine and colorectal cancer screening for Medicare Advantage members, retroactively effective to January 1, 202​5
  • to provide notice, in accordance with CMS, of updated high-risk diagnosis codes for colorectal cancer screening for Medicare Advantage members, retroactively effective to October 1, 2024 
Updated Preventive Coverage for Hepatitis B Vaccine and Colorectal Cancer Screening (Retroactively Effective)55e33aac-165c-42eb-b582-a0c70f6e4837
4/1/2025
04/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products
0.1
The intent of this document is to communicate Medicare Advantage Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 04/01/2025, unless otherwise noted. 

For more information related to these services, please refer to specific policies when applicable.​​​​​​​

04/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products02f4a5f6-8e17-4e09-a15f-5df2cd6cf850
1 - 10Next