Medical and Pharmacy Coverage Policies

Effective Date	Policy Name	Reviewed Date
4/1/2026	Facility Based Sleep Studies - Medicare Advantage	3/10/2026
9/1/2026	Foot Surgical Procedures - Medicare Advantage	8/11/2026
7/29/2026	Fractional Flow Reserve with Computed Tomography - MEDICAID - OKLAHOMA	4/7/2026
7/20/2026	Freestanding Psychiatric Hospital for Adults In Lieu of Service - MEDICAID - LOUISIANA	10/7/2025
8/3/2026	Functional Electrical Stimulators (Non-Pain) - Medicare Advantage	7/14/2026
7/20/2026	Functional Family Therapy - MEDICAID - LOUISIANA	10/7/2025

Medical Coverage Policies