| News & Announcements | Coverage of Immune Globulin Intravenous (IVIG) and Subcutaneous (SCIG) for Measles Post-Exposure Prophylaxis in Medicare Advantage Members | | | | | | 1/16/2026 | | | |
| New Policies | Cardiac Contractility Modulation | MA05.038 | | 10/28/2025 | | | 1/1/2026 | This is a New Policy. | | |
| New Policies | Nipocalimab-aahu (Imaavy) | MA08.187 | | 1/1/2026 | | | 1/2/2026 | This is a New Policy. | | |
| New Policies | Remote Electrical Neuromodulation for Migraines | MA05.071 | | 1/1/2026 | | | 1/2/2026 | This is a New Policy. | | |
| New Policies | Renal Denervation for Uncontrolled Hypertension | MA11.120 | | 10/28/2025 | | | 1/5/2026 | This is a New Policy. | | |
| Updated Policies | Tocilizumab and Related Biosimilars for Intravenous Infusion and Subcutaneous Injection | MA08.045o | | 1/1/2026 | | | 1/2/2026 | Coverage and/or Reimbursement Position;Medical Necessity Criteria | | |
| Updated Policies | Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta) | MA08.018l | | 1/1/2026 | | | 1/2/2026 | Coverage and/or Reimbursement Position | | |
| Updated Policies | Eculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™) for intravenous administration | MA08.044l | | 1/1/2026 | | | 1/2/2026 | Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Efgartigimod alfa-fcab (Vyvgart) and efgartigimod-alfa and hyaluronidase-qvfc (Vyvgart Hytrulo) | MA08.142e | | 1/1/2026 | | | 1/2/2026 | Medical Necessity Criteria | | |
| Updated Policies | Treatment of Obesity and Bariatric Surgery for Treatment of Morbid Obesity | MA11.051c | | 1/1/2026 | | | 1/2/2026 | Coverage and/or Reimbursement Position;Medical Coding | | |
| Updated Policies | Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease | MA08.151e | | 1/1/2026 | | | 1/2/2026 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Coagulation Factors | MA08.004z | | 1/1/2026 | | | 1/2/2026 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®) | MA08.022t | | 1/1/2026 | | | 1/2/2026 | Coverage and/or Reimbursement Position;Medical Coding | | |
| Updated Policies | Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists, VEGF Biosimilars, and Combination VEGF/Angiopoietin-2 (Ang-2) Inhibitors | MA08.073u | | 1/1/2026 | | | 1/2/2026 | Medical Necessity Criteria | | |
| Updated Policies | Efbemalenograstim alfa-vuxw (Ryzneuta®), Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars | MA08.082o | | 1/1/2026 | | | 1/2/2026 | Coverage and/or Reimbursement Position;Medical Necessity Criteria | | |
| Updated Policies | Radiation Therapy Services (AmeriHealth) | MA09.020v | | 1/1/2026 | | | 1/5/2026 | Medical Necessity Criteria | | |
| Updated Policies | Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) | MA07.004k | | 10/1/2025 | | | 1/5/2026 | Medical Coding | | |
| Updated Policies | Peroral Endoscopic Myotomy (POEM) Procedures | MA11.117a | | 1/5/2026 | | | 1/5/2026 | Medical Coding | | |
| Updated Policies | Musculoskeletal Services | MA00.047q | | 11/17/2025 | | | 1/6/2026 | Medical Necessity Criteria | | |
| Updated Policies | Durable Medical Equipment (DME) | MA05.044v | 10/10/2025 10:00 AM | 1/10/2026 | | | 1/9/2026 | Coverage and/or Reimbursement Position | | |
| Updated Policies | Not Medically Necessary Services and Obsolete or Unreliable Diagnostic Tests | MA00.001f | | 1/12/2026 | | | 1/12/2026 | Medical Necessity Criteria;Medical Coding | | |
| Reissue Policies | Acupuncture | MA12.004e | | 1/1/2025 | 1/21/2026 | | 1/21/2026 | | | |
| Reissue Policies | Evaluation and Treatment of Erectile Dysfunction (ED) | MA11.079e | | 1/2/2024 | 1/21/2026 | | 1/21/2026 | | | |
| Reissue Policies | Nucleoplasty | MA11.101 | | 1/1/2015 | 1/21/2026 | | 1/21/2026 | | | |
| Reissue Policies | Cryosurgical Ablation of the Prostate Gland | MA11.022a | | 4/7/2015 | 1/21/2026 | | 1/21/2026 | | | |
| Reissue Policies | Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence | MA11.028l | | 10/1/2024 | 1/21/2026 | | 1/21/2026 | | | |
| Coding Update | Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®) | MA08.137e | | 1/1/2026 | | | 1/1/2026 | | | |
| Coding Update | Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH) | MA11.004q | | 1/1/2026 | | | 1/1/2026 | | | |
| Coding Update | Enzyme Replacement for the Treatment of Gaucher's Disease | MA08.023d | | 1/2/2026 | | | 1/2/2026 | | | |
| Coding Update | Hyaluronan Therapies for Osteoarthritis of the Knee | MA11.023m | | 1/2/2026 | | | 1/2/2026 | | | |
| Coding Update | External Infusion Pumps | MA05.060e | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Percutaneous Coronary Intervention, Coronary Angiography, and Arterial Ultrasound | MA11.113m | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Therapeutic Transcranial Magnetic Stimulation (TMS) | MA07.035g | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Reconstructive Breast Surgery | MA11.030i | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Tumor Treating Fields | MA07.032a | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Telehealth Services | MA00.036l | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Psychiatric Collaborative Care Management (CoCM) | MA00.052b | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Reimbursement for the Administration of Immunizations | MA07.019d | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Medicare Part B vs. Part D Crossover Drugs | MA08.007at | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Treatments for Complex Regional Pain Syndrome (CRPS) | MA08.026m | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence | MA11.001l | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | High-Technology Radiology Services | MA09.002af | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis | MA11.097f | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Musculoskeletal Services | MA00.047r | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Percutaneous Discectomy | MA11.096c | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Remote Patient Monitoring | MA12.010d | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Ablation of Lung Tumors | MA11.052f | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Endovascular Stent Graft Repair of Thoracic Aortic Aneurysms and Nonaneurysmal Lesions | MA11.062d | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery | MA11.056i | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Photodynamic Therapy (PDT) Using Levulan® Kerastick® or Ameluz® (Aminolevulinic Acid HCl [ALA]) | MA07.056f | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Low-Level Laser Therapy | MA07.036e | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | MA11.015af | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Procedures for the Treatment of Gastroesophageal Reflux Disease (GERD) | MA11.055g | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence | MA11.028l | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Scar Revision | MA11.078d | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG) | MA08.009x | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Intravenous Infliximab and Related Biosimilars | MA08.019q | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Linvoseltamab-gcpt (Lynozyfic) | MA08.188a | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®) | MA08.085k | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Telisotuzumab vedotin-tllv (Emrelis™) | MA08.040a | | 1/1/2026 | | | 1/2/2026 | | | |
| Coding Update | Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis | MA11.097f | | 1/1/2026 | | | 1/5/2026 | | | 1/5/2026 |
| Coding Update | Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis | MA11.097f | | 1/1/2026 | | | 1/5/2026 | | | |
| Coding Update | Preventive Care Services | MA00.003af | | 1/1/2026 | | | 1/5/2026 | | | |
| Coding Update | Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus | MA00.037n | | 1/1/2026 | | | 1/6/2026 | | | |
| Coding Update | Musculoskeletal Services | MA00.047r | | 1/1/2026 | | | 1/6/2026 | | | |
| Coding Update | Care Management and Care Planning Services | MA00.006p | | 1/1/2026 | | | 1/7/2026 | | | |
| Coding Update | Treatments for Complex Regional Pain Syndrome (CRPS) | MA08.026m | | 1/1/2026 | | | 1/8/2026 | | | 1/8/2026 |
| Coding Update | Treatments for Complex Regional Pain Syndrome (CRPS) | MA08.026m | | 1/1/2026 | | | 1/8/2026 | | | |
| Coding Update | Bundled Procedure Codes | MA00.026y | | 1/1/2026 | | | 1/9/2026 | | | |
| Coding Update | Direct Access to Obstetrics/Gynecology (OB/GYN) Services | MA00.032h | | 1/1/2026 | | | 1/9/2026 | | | |
| Coding Update | 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 | MA03.003r | | 1/1/2026 | | | 1/12/2026 | | | |
| Coding Update | Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG) | MA08.009x | | 1/1/2026 | | | 1/13/2026 | | | 1/13/2026 |
| Coding Update | Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG) | MA08.009x | | 1/1/2026 | | | 1/13/2026 | | | |
| Coding Update | Radiologic Guidance and/or Supervision and Interpretation of a Procedure | MA00.019k | | 1/1/2026 | | | 1/22/2026 | | | |
