Medical and Pharmacy Coverage Policies

Effective Date	Policy Name	Reviewed Date
6/1/2026	Umbilical Cord Blood Transplantation - Medicare Advantage	5/12/2026
5/1/2026	Upper and Lower Extremity Computed Tomography Angiography (CTA) - Medicare Advantage	1/13/2026
7/1/2026	Upper and Lower Extremity Magnetic Resonance Angiography/Venography - Medicare Advantage	6/9/2026
7/1/2026	Upper and Lower Extremity Magnetic Resonance Imaging (MRI) - Medicare Advantage	6/9/2026
7/22/2026	Uterine Fibroid Surgical Treatments - MEDICAID - KENTUCKY	3/3/2026
4/1/2026	Uterine Fibroid Surgical Treatments - Medicare Advantage	3/10/2026

Medical Coverage Policies