amerihealth
Advanced Search
MPDocType
  
Title
  
MPPolicyNumber
  
MPNotificationIssuedDate
  
MPEffectiveDate
  
MPReissuedDate
  
MPArchiveNotifEffDate
  
MPSALogCreatedOn
  
MPPolicyChangeTypeslt
  
MPRevisionDate
  
MPSiteActivityRemovedDate
  
News & AnnouncementsPreventive Coverage Update of Combined Chlamydia and Gonorrhea Testing for Medicare Advantage Members (Retroactively effective 01/01/2026)3/23/2026
News & AnnouncementsAdditional Services Eligible Through Telehealth for Medicare Advantage Members (Retroactively Effective 01/01/2026)3/26/2026
NotificationsMusculoskeletal ServicesMA00.047s3/2/2026 11:00 AM6/1/20263/2/2026Medical Necessity Criteria
NotificationsLevel of Care for Elective Procedures (Hospital Inpatient to Hospital Outpatient Level of Care)MA12.0123/2/2026 12:00 PM6/1/20263/2/2026This is a New Policy.
NotificationsPresumptive and Definitive Drug Testing in Substance Abuse and Pain Management TreatmentsMA06.025s3/6/2026 10:00 AM6/5/20263/6/2026Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
NotificationsApheresis TherapyMA06.001g3/10/2026 10:00 AM6/8/20263/10/2026Coverage and/or Reimbursement Position;Medical Necessity Criteria
NotificationsSite of Care for Elective Procedures [Hospital Outpatient Setting to Ambulatory Surgical Center (ASC)]MA12.0053/2/2026 3:00 PM6/1/20263/25/2026This is a New Policy.3/25/2026
New PoliciesMultiple Procedure Payment Reduction (MPPR) Guidelines for Transvaginal and Transabdominal UltrasoundsMA00.05712/2/2025 2:00 PM3/2/20263/2/2026This is a New Policy.
New PoliciesReimbursement of Surgical Pathology Services for Prostate BiopsyMA00.05812/2/2025 2:00 PM3/2/20263/2/2026This is a New Policy.
New PoliciesReimbursement for Emergent Inpatient AdmissionsMA00.0592/3/2026 3:00 PM3/5/20263/5/2026This is a New Policy.
Updated PoliciesReimbursement for Certain Evaluation and Management (E/M) ServicesMA00.049c12/2/2025 3:00 PM3/2/20263/2/2026Coverage and/or Reimbursement Position
Updated PoliciesMirikizumab-mrkz (Omvoh®) for Intravenous UseMA08.169a12/16/2025 9:00 AM3/16/20263/16/2026Medical Necessity Criteria
Updated PoliciesTotal Parenteral Nutrition (TPN) / Intradialytic Parenteral Nutrition (IDPN)MA08.008h12/16/2025 3:00 PM3/16/20263/16/2026Medical Necessity Criteria
Updated PoliciesIntravenous (IV) Iron PreparationsMA08.150a12/23/2025 9:00 AM3/23/20263/23/2026Medical Necessity Criteria
Updated PoliciesInebilizumab-cdon (Uplizna®)MA08.126c3/23/20263/23/2026Medical Necessity Criteria;Medical Coding
Updated PoliciesRadiation Therapy Services (AmeriHealth)MA09.020w2/25/20263/23/2026Coverage and/or Reimbursement Position;Medical Necessity Criteria
Updated PoliciesInterleukin-5 (IL-5) Antagonist (e.g., Cinqair®, Exdensur, Nucala®) and IL-5 Receptor Antagonist (e.g., Fasenra®)MA08.024n3/23/20263/23/2026Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesLuspatercept–aamt (Reblozyl®)MA08.110e3/23/20263/23/2026Medical Necessity Criteria;Medical Coding
Updated PoliciesOmalizumab (Xolair®) and related biosimilarsMA08.025i3/23/20263/23/2026Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesNivolumab (Opdivo®), Nivolumab and Hyaluronidase-nvhy (Opdivo Qvantig™) MA08.120g3/23/20263/23/2026Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Updated PoliciesDermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and SeptorhinoplastyMA11.099f12/26/2025 9:00 AM3/30/20263/30/2026Coverage and/or Reimbursement Position;Medical Coding3/30/2026
Updated PoliciesMedicare Part B vs. Part D Crossover DrugsMA08.007au3/30/20263/30/2026Coverage and/or Reimbursement Position
Reissue PoliciesComputer-Assisted Musculoskeletal Surgical Navigational Orthopedic ProcedureMA11.088c1/1/20243/4/20263/4/2026
Reissue PoliciesExtracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal ConditionsMA11.087c1/1/20243/4/20263/4/2026
Reissue PoliciesAnesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint ManagementMA01.008d10/1/20253/4/20263/4/2026
Reissue PoliciesPercutaneous Intradiscal Annuloplasty (IDET/PIRFT)MA11.0251/1/20243/4/20263/4/2026
Reissue PoliciesManipulation Under AnesthesiaMA11.091b1/1/20243/4/20263/4/2026
Reissue PoliciesNivolumab and relatlimab-rmbw (Opdualag™) for intravenous useMA08.152d6/16/20253/4/20263/4/2026
Reissue PoliciesApplication and Removal of TattoosMA11.0721/1/20153/4/20263/4/2026
Reissue PoliciesHeating Pads and Heat LampsMA05.029d4/21/20253/4/20263/4/2026
Reissue PoliciesCanes and CrutchesMA05.052c4/21/20253/4/20263/4/2026
Reissue PoliciesOrthopedic FootwearMA05.012c1/1/20243/4/20263/4/2026
Reissue PoliciesAutonomic Nervous System TestingMA07.027h6/16/20253/4/20263/4/2026
Reissue PoliciesChemical PeelsMA11.103c12/29/20253/4/20263/4/2026
Reissue PoliciesNerve Fiber Density TestingMA06.023c1/1/20243/4/20263/4/2026
Reissue PoliciesTracheostomy Care SuppliesMA05.034a5/6/20243/4/20263/4/2026
Reissue PoliciesCommode ChairsMA05.036c4/21/20253/4/20263/4/2026
Reissue PoliciesWalkersMA05.037b10/1/20253/4/20263/4/2026
Reissue PoliciesSurgical Treatment of NailsMA11.036e4/21/20253/4/20263/4/2026
Reissue PoliciesUltraviolet Light Therapy for the Treatment of Dermatological ConditionsMA07.002i10/1/20243/4/20263/4/2026
Reissue PoliciesProcedures for the Treatment of AcneMA11.109a10/1/20163/4/20263/4/2026
Reissue PoliciesPhotodynamic Therapy (PDT) Using Levulan® Kerastick® or Ameluz® (Aminolevulinic Acid HCl [ALA])MA07.056f1/1/20263/4/20263/4/2026
Reissue PoliciesProtein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate CancerMA06.0361/27/20253/4/20263/4/2026
Reissue PoliciesAgalsidase beta (Fabrazyme) and pegunigalsidase alfa-iwxj (Elfabrio)MA08.033d9/9/20243/4/20263/5/2026
Reissue PoliciesMagnetic Resonance Imaging (MRI)-Guided Focused Ultrasound AblationMA09.021f1/1/20253/4/20263/5/2026
Reissue PoliciesLabiaplastyMA11.067e2/24/20253/4/20263/5/2026
Reissue PoliciesMentoplasty or GenioplastyMA11.080c10/1/20253/4/20263/5/2026
Reissue PoliciesNusinersen (Spinraza®)MA08.086d1/1/20243/4/20263/5/2026
Reissue PoliciesPhotodynamic Therapy Using Verteporfin (Visudyne®)MA07.003f2/2/20263/4/20263/5/2026
Reissue PoliciesScanning Computerized Ophthalmic Diagnostic Imaging (SCODI)MA07.004j10/1/20253/4/20263/5/2026
Reissue PoliciesRhytidectomy and/or Cervicoplasty With or Without Liposuction and/or PlatysmaplastyMA11.075b1/1/20253/4/20263/5/2026
Reissue PoliciesPositron Emission Mammography (PEM)MA09.0151/1/20243/4/20263/5/2026
Reissue PoliciesSurgery for GynecomastiaMA11.110a12/19/20223/4/20263/5/2026
Reissue PoliciesPulse Oximetry Device in the Home SettingMA05.042a1/1/20243/18/20263/18/2026
Reissue PoliciesDrug-Eluting Beads and Bland Embolization for the Treatment of Hepatic MalignanciesMA07.041c10/1/202410/29/20253/27/20263/27/2026
Coding UpdateProcedures for the Treatment of Gastroesophageal Reflux Disease (GERD)MA11.055g1/1/20263/5/20263/5/2026
Coding UpdateExternal Infusion PumpsMA05.060f3/20/20263/20/2026