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10/1/2026
10/01/2026 updates to the Medicare Advantage Experimental/Investigational Services policy
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This document is intended to communicate upcoming updates to the Experimental/Investigational Services policy, effective 10/1/2026. These updates reflect routine maintenance of the policy, including the termination, revision, addition and/or removal of codes and services. These updates can be driven by the release of new codes, changes in coverage determinations, the archival of other medical policies, as well as the development or revision of other medical policies where certain codes have been identified to be more clinically applicable.

10/01/2026 updates to the Medicare Advantage Experimental/Investigational Services policy91e3dc4d-0605-4f23-a177-a243d5784290
10/1/2026
10/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products
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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 10/01/2026.

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

10/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Productsd3708d12-273d-485c-adea-971931b76d38
9/21/2026
New Preventive Coverage of mRNA influenza Vaccine (MFLUSIVA) for Medicare Advantage Members effective August 5, 2026
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Effective August 5, 2026, the purpose of this article is to communicate new preventive coverage of the mRNA influenza vaccine (MFLUSIVA) for Medicare Advantage members in the prevention of influenza disease caused by influenza virus subtypes A and type B in individuals 50 years of age and older.

New Preventive Coverage of mRNA influenza Vaccine (MFLUSIVA) for Medicare Advantage Members effective August 5, 2026e0757ae5-a47b-44a4-8934-4600e4cf2e3a
8/27/2026
Updated Preventive Coverage for Colorectal Cancer Screening to add SimpleScreen™ CRC for Medicare Advantage Members (Effective July 24, 2026)
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The purpose of this communication is to provide notice of updated preventive coverage for Medicare Advantage members to add SimpleScreen™ CRC​ as a preventive service effective July 24, 2026.​

Updated Preventive Coverage for Colorectal Cancer Screening to add SimpleScreen™ CRC for Medicare Advantage Members (Effective July 24, 2026)92e433b5-fe87-41b0-813c-db701da1f921
8/3/2026
High-Intensity Focused Ultrasound (HIFU) in the Treatment of Malignant Prostate Tissue for Medicare Advantage Members (Effective July 1, 2026)
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This communication is being issued to provide notification of the updated coverage position for high-intensity focused ultrasound in the treatment of malignant prostate tissue for Medicare Advantage members.​
  • Effective July 01, 2026, the coverage position for high-intensity focused ultrasound​ has been updated. ​​
High-Intensity Focused Ultrasound (HIFU) in the Treatment of Malignant Prostate Tissue for Medicare Advantage Members (Effective July 1, 2026)f834ec1f-b136-41fc-bbbd-ec16f74c24bc
7/1/2026
07/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products
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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 07/01/2026.

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

07/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products07f57deb-b78d-4c5c-af84-d9438fb0ae2b
6/30/2026
Updated Preventive Coverage for Colorectal Cancer Screening to add Colosense® for Medicare Advantage Members (Effective June 8, 2026).
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In accordance with CMS, this communication provides notice of updated preventive coverage for Medicare Advantage members for Colorectal Cancer Screening: 
  • Effective June 8, 2026, CMS ​updated the colorectal screening coverage to add ColoSense®​ as a preventive service.  ​
Updated Preventive Coverage for Colorectal Cancer Screening to add Colosense® for Medicare Advantage Members (Effective June 8, 2026).537882e5-9dec-4955-8506-1898940d7eb2
4/16/2026
04/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products (updated April 17, 2026)
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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 04/01/2026.

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

Note:
  • ​This document replaces the version published on April 1, 2026.​​​
  • Procedure code L2221 has been removed from the Experimental/Investigational section and has been added to the Eligible section.

04/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products (updated April 17, 2026)57884ca8-cc81-4a82-b5a1-2495be678bb6
3/23/2026
Preventive Coverage Update of Combined Chlamydia and Gonorrhea Testing for Medicare Advantage Members (Retroactively effective 01/01/2026)
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The purpose of this communication is to provide notice of updated preventive coverage for chlamydia and gonorrhea testing. ​​
Preventive Coverage Update of Combined Chlamydia and Gonorrhea Testing for Medicare Advantage Members (Retroactively effective 01/01/2026)dad9538b-b539-483e-8e31-11656d49a6fc
1/16/2026
Coverage of Immune Globulin Intravenous (IVIG) and Subcutaneous (SCIG) for Measles Post-Exposure Prophylaxis in Medicare Advantage Members
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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
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