Medical Policies

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Showing 201– 250 of 346 Results
Title Last Updated Category
Magnetic Resonance Spectroscopy (MRS) Open a PDF 6.01.03 2026-02-13 Radiology (x-rays) & Imaging
Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD) (Effective 2026-10-15) Open a PDF 7.01.89 2026-07-15 Digestive System (Gastroenterology)
Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD) Open a PDF 7.01.89 2025-04-23 Digestive System (Gastroenterology)
Management of Dry Eye Syndrome and Meibomian Gland Dysfunction (e.g., LipiFlow) Open a PDF 9.01.19 2025-12-23 Eyes (Ophthalmology)
Maze Procedures for Atrial Fibrillation and Flutter Open a PDF 7.01.27 2026-06-25 Heart & Blood Vessels (Cardiovascular)
Measurable Residual Disease (MRD) Assessment Testing Open a PDF 2.02.54 2026-08-25 Lab Tests (pathology)
Medical Management Obstructive Sleep Apnea (OSA) Open a PDF 1.01.07 2025-11-14 Lungs (Respiratory)
Medical Response to Contamination from Terrorist Attacks Open a PDF 11.01.09 2026-08-25 Miscellaneous
Medically Necessary Services Open a PDF 11.01.15 2025-10-22 Miscellaneous
Metal-on-Metal Total Hip Resurfacing (Effective 2026-10-15) Open a PDF 7.01.74 2026-07-15 Bone & Joints (Orthopedic)
Metal-on-Metal Total Hip Resurfacing Open a PDF 7.01.74 2025-07-15 Bone & Joints (Orthopedic)
Minimally Invasive Treatments for Benign Prostatic Hyperplasia (BPH) Open a PDF 7.01.104 2026-08-04 Urinary System (Genitourinary)
Molecular Marker Testing of the Thyroid Open a PDF 2.02.49 2025-11-25 Genetic Disease (Inherited Disease)
Molecular Testing in the Management of Pulmonary Nodules Open a PDF 2.02.58 2025-10-22 Lab Tests (pathology)
Molecular Testing of Tumor Tissue to Identify Targeted Therapies for Cancers Open a PDF 2.02.51 2026-02-23 Genetic Disease (Inherited Disease)
Negative Pressure Wound Therapy (Vacuum-Assisted Closure) Open a PDF 01.01.38 2026-09-21 Skin (Dermatology)
Neuropsychological and Psychological Testing Open a PDF 3.01.24 2026-04-28 Behavioral Health (Psychiatry/Psychology)
New/Emerging Technology & Services Open a PDF 11.01.27 2025-11-25 Miscellaneous
New/Emerging Technology and Services Code List Open a PDF 11.01.27 2026-04-30 Miscellaneous
Non-Invasive Prenatal Testing Open a PDF 2.02.25 2026-08-25 Lab Tests (pathology)
Non-Invasive Surface Electrical Stimulation for Pain and Rehabilitation Open a PDF 1.01.61 2026-05-27 Durable Medical Equipment & Supplies
Orthopedic Joint Procedures of the Hip for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Members (Effective 2027-01-01) Open a PDF 7.01.121 2026-10-05 Bone & Joints (Orthopedic)
Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Members (Effective 2027-01-01) Open a PDF 7.01.123 2026-10-05 Bone & Joints (Orthopedic)
Orthopedic Joint Procedures of the Shoulder for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Members (Effective 2027-01-01) Open a PDF 7.01.125 2026-10-05 Bone & Joints (Orthopedic)
Orthotics Open a PDF 1.01.25 2026-05-15 Bone & Joints (Orthopedic)
Osteochondral Grafting of the Knee (Effective 2026-10-15) Open a PDF 7.01.59 2026-07-15 Bone & Joints (Orthopedic)
Osteochondral Grafting of the Knee Open a PDF 7.01.59 2025-07-11 Bone & Joints (Orthopedic)
Out-of-Network Services Open a PDF 11.01.14 2026-01-27 Miscellaneous
Ovarian and Internal Iliac Vein Endovascular Occlusion as a Treatment of Pelvic Congestion Syndrome Open a PDF 4.01.10 2026-09-21 Women's Health (Obstetrics & Gynecology)
Pacemakers and Cardiac Resynchronization Therapy (CRT) Devices Open a PDF 7.01.58 2026-03-13 Heart & Blood Vessels (Cardiovascular)
Pain Management Techniques for Knee Pain Open a PDF 7.01.100 2026-07-21 Bone & Joints (Orthopedic)
Pancreas Transplant: (Pancreas Transplant Alone, Pancreas Transplant after Kidney Transplant, Simultaneous Pancreas Kidney Transplant): Islet Cell Transplant Open a PDF 7.02.01 2026-03-24 Transplants
Partial Hospitalization for Substance Use Disorders Open a PDF 3.01.18 2026-08-25 Behavioral Health (Psychiatry/Psychology)
Patient Lifts (Effective 2026-11-16) Open a PDF 1.01.08 2026-09-14 Home Care
Patient Lifts (e.g., Hoyer, Saralift, Seat Lift, Chair Mechanisms, and Ceiling Lifts) Open a PDF 1.01.08 2026-09-14 Home Care
Pelvic Floor Electrical Stimulation as a Treatment for Urinary or Fecal Incontinence Open a PDF 1.01.19 2026-03-24 Urinary System (Genitourinary)
Showing 201– 250 of 346 Results

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