| Effective Date | Policy Name | Reviewed Date |
| 9/23/2026 |
Ablation (Cancer and Noncancer Indications) - MEDICAID - FLORIDA
| 3/3/2026 |
| 9/23/2026 |
Applied Behavior Analysis - MEDICAID - SOUTH CAROLINA
| 6/2/2026 |
| 9/23/2026 |
Cochlear Implant - MEDICAID - LOUISIANA
| 9/2/2025 |
| 9/23/2026 |
Gene Expression Profiling for Cancer Indications - MEDICAID - INDIANA
| 6/2/2026 |
| 9/23/2026 |
Gene Expression Profiling for Cancer Indications - MEDICAID - MICHIGAN
| 6/2/2026 |
| 9/23/2026 |
Gene Expression Profiling for Cancer Indications - MEDICAID - SOUTH CAROLINA
| 6/2/2026 |
| 9/23/2026 |
Genetic Testing for Diagnosis of Inherited Conditions - MEDICAID - KENTUCKY
| 5/5/2026 |
| 9/23/2026 |
Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - INDIANA
| 6/2/2026 |
| 9/23/2026 |
Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - MICHIGAN
| 6/2/2026 |
| 9/23/2026 |
Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - SOUTH CAROLINA
| 6/2/2026 |
| 9/23/2026 |
Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - KENTUCKY
| 5/5/2026 |
| 9/23/2026 |
Molecular Biomarker Testing for Noncancer Indications - MEDICAID - KENTUCKY
| 5/5/2026 |
| 9/23/2026 |
Orthotics - MEDICAID - SOUTH CAROLINA
| 6/2/2026 |
| 9/16/2026 |
Applied Behavior Analysis - MEDICAID - OKLAHOMA
| 5/5/2026 |
| 9/16/2026 |
Cutaneous Vascular Lesion Removal - MEDICAID - KENTUCKY
| 9/2/2025 |
| 9/16/2026 |
Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - FLORIDA
| 3/3/2026 |
| 9/16/2026 |
Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - FLORIDA
| 5/5/2026 |
| 9/16/2026 |
Pharmacogenomics Testing - MEDICAID - FLORIDA
| 4/7/2026 |
| 9/16/2026 |
Spinal Decompression Surgery - MEDICAID - FLORIDA
| 4/7/2026 |
| 9/16/2026 |
Spinal Fusion and Stabilization Surgery - MEDICAID - FLORIDA
| 3/3/2026 |
| 9/11/2026 |
Shoulder Arthroscopy - Medicare Advantage
| 8/28/2026 |
| 9/10/2026 |
Molecular Markers in Fine Needle Aspirates of Thyroid Nodules - Medicare Advantage
| 8/11/2026 |
| 9/10/2026 |
Transcatheter Valve Procedures - Medicare Advantage
| 1/13/2026 |
| 9/9/2026 |
Pharmacogenomics Testing - MEDICAID - KENTUCKY
| 4/7/2026 |
| 9/2/2026 |
Cardiac Stress Testing - MEDICAID - FLORIDA
| 5/5/2026 |
| 9/2/2026 |
Genetic Testing for Diagnosis of Inherited Conditions - MEDICAID - FLORIDA
| 5/5/2026 |
| 9/2/2026 |
Genetic Testing for Diagnosis of Inherited Conditions - MEDICAID - OKLAHOMA
| 5/5/2026 |
| 9/2/2026 |
Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - OKLAHOMA
| 5/5/2026 |
| 9/2/2026 |
Molecular Biomarker Testing for Noncancer Indications - MEDICAID - FLORIDA
| 5/5/2026 |
| 9/1/2026 |
Advanced Imaging of the Head and Neck - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Ambulatory Cardiac Monitoring Devices - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Benign Prostatic Hyperplasia Treatments - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Blepharoplasty, Blepharoptosis Repair and Brow Lift - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Computed Tomography Angiography (CTA) of the Abdominal Aorta - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Dynamic Spinal Stabilization and Vertebral Body Tethering for Spinal Deformities - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Foot Surgical Procedures - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Gender Affirmation Surgery - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Genetic Testing for Diagnosis of Inherited Conditions - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Genetic Testing for Hereditary Cardiovascular Disease - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Home Mechanical Ventilators - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Injections for Pain Conditions - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Prosthetics - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Psychiatric Inpatient Hospitalization - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Psychiatric Partial Hospital Program Services - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Radiofrequency Tumor Ablation - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Skin and Tissue Substitutes - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Spinal Fusion Surgery - Medicare Advantage
| 8/11/2026 |
| 9/1/2026 |
Waskyra (etuvetidigene autotemcel) - Medicare Advantage
| 8/11/2026 |
| 8/31/2026 |
Colorectal Cancer Screening - Medicare Advantage
| 3/10/2026 |
| 8/30/2026 |
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - Medicare Advantage
| 11/11/2025 |
| 8/26/2026 |
Cardiac Stress Testing - MEDICAID - MICHIGAN
| 5/5/2026 |
| 8/26/2026 |
Cardiac Stress Testing - MEDICAID - SOUTH CAROLINA
| 5/5/2026 |
| 8/26/2026 |
Cardiac Stress Testing - MEDICAID - VIRGINIA
| 5/5/2026 |
| 8/26/2026 |
Crisis Stabilization for Adults - MEDICAID - LOUISIANA
| 10/7/2025 |
| 8/26/2026 |
Genetic Testing for Diagnosis of Inherited Conditions - MEDICAID - INDIANA
| 5/5/2026 |
| 8/26/2026 |
Genetic Testing for Diagnosis of Inherited Conditions - MEDICAID - MICHIGAN
| 5/5/2026 |
| 8/26/2026 |
Genetic Testing for Diagnosis of Inherited Conditions - MEDICAID - SOUTH CAROLINA
| 5/5/2026 |
| 8/26/2026 |
Genetic Testing for Diagnosis of Inherited Conditions - MEDICAID - VIRGINIA
| 5/5/2026 |
| 8/26/2026 |
Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - INDIANA
| 5/5/2026 |
| 8/26/2026 |
Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - SOUTH CAROLINA
| 5/5/2026 |
| 8/26/2026 |
Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - VIRGINIA
| 5/5/2026 |
| 8/26/2026 |
Molecular Biomarker Testing for Noncancer Indications - MEDICAID - SOUTH CAROLINA
| 5/5/2026 |
| 8/26/2026 |
Molecular Biomarker Testing for Noncancer Indications - MEDICAID - VIRGINIA
| 5/5/2026 |
| 8/26/2026 |
Prostate Artery Embolization - MEDICAID - ILLINOIS
| 5/5/2026 |
| 8/26/2026 |
Prostate Artery Embolization - MEDICAID - INDIANA
| 5/5/2026 |
| 8/26/2026 |
Prostate Artery Embolization - MEDICAID - MICHIGAN
| 5/5/2026 |
| 8/26/2026 |
Therapeutic Group Home - MEDICAID - LOUISIANA
| 10/7/2025 |
| 8/12/2026 |
RECELL Autologous Cell Harvesting Device - MEDICAID - KENTUCKY
| 2/3/2026 |
| 8/12/2026 |
Skin and Tissue Substitutes - MEDICAID - KENTUCKY
| 2/3/2026 |
| 8/10/2026 |
Noninvasive Tests for Hepatic Fibrosis - Medicare Advantage
| 5/12/2026 |
| 8/6/2026 |
Neuroablative Techniques for Chronic Pain - Medicare Advantage
| 2/10/2026 |
| 8/5/2026 |
Multi-Systemic Therapy - MEDICAID - LOUISIANA
| 10/7/2025 |
| 8/5/2026 |
Spinal Decompression Surgery - MEDICAID - OHIO
| 4/7/2026 |
| 8/5/2026 |
Spinal Fusion and Stabilization Surgery - MEDICAID - KENTUCKY
| 3/3/2026 |
| 8/3/2026 |
Amtagvi (lifileucel) - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Breast Excision and Mastectomy - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Breast Reconstruction - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Cardiac Catheterization and Coronary Angiography - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Cardiac Electrophysiological Studies and Cardiac Catheter Ablation - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Cardioverter Defibrillators/Cardiac Resynchronization Therapy - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Carpal Tunnel Syndrome Surgical Treatments - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Chimeric Antigen Receptor (CAR) T-cell Therapy - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Comprehensive Genomic Profiling and Multigene Panel Testing for Solid Tumors - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Cryoablation - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Functional Electrical Stimulators (Non-Pain) - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Gene Expression Profiling for Noncancer Indications - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Genetic Testing for Hereditary Breast, Ovarian, Pancreatic and Prostate Cancer - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Genetic Testing for Hereditary Cancer - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Genetic and Biomarker Testing for Neurodegenerative Disease - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Liquid Biopsy - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Negative Pressure Wound Therapy - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Orthotics - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Penile Prosthesis Implant for Erectile Dysfunction - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Percutaneous Coronary Intervention - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Peripheral Nerve Stimulators - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Pharmacogenomics Testing - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Shoulder Arthroplasty - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Superficial Radiation Therapy - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Transcatheter and Device-Based Hemodynamic Management Procedures - Medicare Advantage
| 7/14/2026 |
| 8/3/2026 |
Ventricular Assist Device, Total Artificial Heart - Medicare Advantage
| 7/14/2026 |
| 7/29/2026 |
Documentation Requirements for Hysterectomy and Sterilization - MEDICAID - LOUISIANA
| 10/7/2025 |
| 7/29/2026 |
Durable Medical Equipment Maintenance and Repair - MEDICAID - LOUISIANA
| 12/2/2025 |
| 7/29/2026 |
Fractional Flow Reserve with Computed Tomography - MEDICAID - OKLAHOMA
| 4/7/2026 |
| 7/29/2026 |
Injections for Chronic Pain Conditions - MEDICAID - OKLAHOMA
| 4/7/2026 |
| 7/29/2026 |
Spinal Decompression Surgery - MEDICAID - OKLAHOMA
| 4/7/2026 |
| 7/22/2026 |
Excessive Skin and Subcutaneous Tissue Removal - MEDICAID - KENTUCKY
| 11/4/2025 |
| 7/22/2026 |
Mobility Assistive Devices (Wheelchairs) - MEDICAID - KENTUCKY
| 8/5/2025 |
| 7/22/2026 |
Multi-Function Oscillation Lung Expansion Therapy - MEDICAID - VIRGINIA
| 4/7/2026 |
| 7/22/2026 |
Neurostimulators - MEDICAID - KENTUCKY
| 3/3/2026 |
| 7/22/2026 |
Pharmacogenomics Testing - MEDICAID - INDIANA
| 4/7/2026 |
| 7/22/2026 |
Pharmacogenomics Testing - MEDICAID - MICHIGAN
| 4/7/2026 |
| 7/22/2026 |
Pharmacogenomics Testing - MEDICAID - SOUTH CAROLINA
| 4/7/2026 |
| 7/22/2026 |
Pharmacogenomics Testing - MEDICAID - VIRGINIA
| 4/7/2026 |
| 7/22/2026 |
Skin and Tissue Substitutes - MEDICAID - OHIO
| 2/3/2026 |
| 7/22/2026 |
Spinal Decompression Surgery - MEDICAID - INDIANA
| 4/7/2026 |
| 7/22/2026 |
Spinal Decompression Surgery - MEDICAID - MICHIGAN
| 4/7/2026 |
| 7/22/2026 |
Spinal Decompression Surgery - MEDICAID - SOUTH CAROLINA
| 4/7/2026 |
| 7/22/2026 |
Spinal Decompression Surgery - MEDICAID - VIRGINIA
| 4/7/2026 |
| 7/22/2026 |
Spinal Fusion and Stabilization Surgery - MEDICAID - OHIO
| 3/3/2026 |
| 7/22/2026 |
Thiopurine S-Methyltransferase Enzyme Activity Testing - MEDICAID - INDIANA
| 4/7/2026 |
| 7/22/2026 |
Thiopurine S-Methyltransferase Enzyme Activity Testing - MEDICAID - VIRGINIA
| 4/7/2026 |
| 7/22/2026 |
Uterine Fibroid Surgical Treatments - MEDICAID - KENTUCKY
| 3/3/2026 |
| 7/20/2026 |
Chiropractic - In Lieu of Services (ILOS) - MEDICAID - LOUISIANA
| 10/7/2025 |
| 7/20/2026 |
Clinical Trials - MEDICAID - LOUISIANA
| 12/2/2025 |
| 7/20/2026 |
Community Brief Crisis Support - MEDICAID - LOUISIANA
| 8/5/2025 |
| 7/20/2026 |
EPSDT Personal Care Services - MEDICAID - LOUISIANA
| 10/7/2025 |
| 7/20/2026 |
Freestanding Psychiatric Hospital for Adults In Lieu of Service - MEDICAID - LOUISIANA
| 10/7/2025 |
| 7/20/2026 |
Functional Family Therapy - MEDICAID - LOUISIANA
| 10/7/2025 |
| 7/20/2026 |
Homebuilders - MEDICAID - LOUISIANA
| 9/2/2025 |
| 7/20/2026 |
Pediatric Day Health Care - MEDICAID - LOUISIANA
| 9/2/2025 |
| 7/20/2026 |
Personal Care Services for Adults with Serious Mental Illness - MEDICAID - LOUISIANA
| 10/7/2025 |
| 7/20/2026 |
Wound Care - MEDICAID - LOUISIANA
| 10/7/2025 |
| 7/15/2026 |
Injections for Chronic Pain Conditions - MEDICAID - KENTUCKY
| 8/5/2025 |
| 7/8/2026 |
Craniosacral Therapy - MEDICAID - OKLAHOMA
| 3/3/2026 |
| 7/5/2026 |
Irreversible Electroporation - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Ambulatory Withdrawal Management - MEDICAID - OHIO
| 6/2/2026 |
| 7/1/2026 |
Breast Imaging - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Community Behavioral Health Rehabilitative Services - MEDICAID - OHIO
| 6/2/2026 |
| 7/1/2026 |
Computed Tomography Angiography (CTA) of the Chest, Abdomen and Pelvis - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Coronary CT Angiography, Fractional Flow Reserve with CT and Adjunctive Testing - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Endobronchial Valve Therapy for Emphysema - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Implantable and External Infusion Pumps for Pain or Spasticity - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Lymphedema - Diagnosis and Treatment - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Mental Health Day Treatment - MEDICAID - OHIO
| 6/2/2026 |
| 7/1/2026 |
Minimal Residual Disease Testing - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Nuclear Imaging for Noncancer Indications - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Ocular Surface Disease Diagnosis and Treatments - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Osteochondral and Subchondral Defects Surgery - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Outpatient Rehabilitation (Skilled Therapy) - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Prostatectomy - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Substance Use Disorder Inpatient Services - Medicare Advantage
| 6/9/2026 |
| 7/1/2026 |
Substance Use Disorder Intensive Outpatient Program - MEDICAID - OHIO
| 6/2/2026 |
| 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 |
| 6/29/2026 |
Multiplex Pathogen Identification Panels for Infectious Disease - MEDICAID - KENTUCKY
| 2/3/2026 |
| 6/29/2026 |
Nonemergency Ambulance Transportation - MEDICAID - KENTUCKY
| 1/6/2026 |
| 6/24/2026 |
Breast Procedures - MEDICAID - KENTUCKY
| 8/5/2025 |
| 6/24/2026 |
Orthognathic Surgery - MEDICAID - OKLAHOMA
| 2/3/2026 |
| 6/24/2026 |
Spinal Fusion and Stabilization Surgery - MEDICAID - OKLAHOMA
| 3/3/2026 |
| 6/22/2026 |
Injections for Chronic Pain Conditions - MEDICAID - FLORIDA
| 2/3/2026 |
| 6/22/2026 |
Obstructive Sleep Apnea Interventional Therapy - MEDICAID - FLORIDA
| 2/3/2026 |
| 6/22/2026 |
Orthognathic Surgery - MEDICAID - FLORIDA
| 2/3/2026 |
| 6/22/2026 |
Skin and Tissue Substitutes - MEDICAID - FLORIDA
| 2/3/2026 |
| 6/22/2026 |
Temporomandibular Disorders - MEDICAID - FLORIDA
| 2/3/2026 |
| 6/17/2026 |
Ablation (Cancer and Noncancer Indications) - MEDICAID - ILLINOIS
| 3/3/2026 |
| 6/17/2026 |
Ablation (Cancer and Noncancer Indications) - MEDICAID - INDIANA
| 3/3/2026 |
| 6/17/2026 |
Ablation (Cancer and Noncancer Indications) - MEDICAID - MICHIGAN
| 3/3/2026 |
| 6/17/2026 |
Ablation (Cancer and Noncancer Indications) - MEDICAID - SOUTH CAROLINA
| 3/3/2026 |
| 6/17/2026 |
Ablation (Cancer and Noncancer Indications) - MEDICAID - VIRGINIA
| 3/3/2026 |
| 6/17/2026 |
Neurostimulators - MEDICAID - INDIANA
| 3/3/2026 |
| 6/17/2026 |
Neurostimulators - MEDICAID - MICHIGAN
| 3/3/2026 |
| 6/17/2026 |
Neurostimulators - MEDICAID - SOUTH CAROLINA
| 3/3/2026 |
| 6/17/2026 |
Neurostimulators - MEDICAID - VIRGINIA
| 3/3/2026 |
| 6/17/2026 |
Spinal Fusion and Stabilization Surgery - MEDICAID - INDIANA
| 3/3/2026 |
| 6/17/2026 |
Spinal Fusion and Stabilization Surgery - MEDICAID - MICHIGAN
| 3/3/2026 |
| 6/17/2026 |
Spinal Fusion and Stabilization Surgery - MEDICAID - SOUTH CAROLINA
| 3/3/2026 |
| 6/17/2026 |
Spinal Fusion and Stabilization Surgery - MEDICAID - VIRGINIA
| 3/3/2026 |
| 6/15/2026 |
Prosthetics - MEDICAID - OHIO
| 9/2/2025 |
| 6/8/2026 |
Gender Affirming Care - MEDICAID - OHIO
| 1/6/2026 |
| 6/5/2026 |
Skin and Tissue Substitutes - MEDICAID - MICHIGAN
| 2/3/2026 |
| 6/3/2026 |
Gene Expression Profiling for Cancer Indications - MEDICAID - FLORIDA
| 12/2/2025 |
| 6/1/2026 |
Advanced Imaging of the Abdomen and Pelvis - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Advanced Imaging of the Chest - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Glaucoma Surgical Treatments - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Headache and Occipital Neuralgia Treatments - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Hyperbaric Oxygen Therapy, Topical Oxygen Therapy - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Lenmeldy (atidarsagene autotemcel) - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Lung Transplant - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Nuclear Imaging for Cancer Indications - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Serological and Fecal Testing for Inflammatory Bowel Disease - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Transesophageal and Transthoracic Echocardiography - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Umbilical Cord Blood Transplantation - Medicare Advantage
| 5/12/2026 |
| 6/1/2026 |
Zevaskyn (prademagene zamikeracel) - Medicare Advantage
| 5/12/2026 |
| 5/27/2026 |
Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - VIRGINIA
| 1/6/2026 |
| 5/27/2026 |
Injections for Chronic Pain Conditions - MEDICAID - VIRGINIA
| 2/3/2026 |
| 5/27/2026 |
Multiplex Pathogen Identification Panels for Infectious Disease - MEDICAID - VIRGINIA
| 2/3/2026 |
| 5/27/2026 |
Obstructive Sleep Apnea Interventional Therapy - MEDICAID - VIRGINIA
| 2/3/2026 |
| 5/27/2026 |
Orthognathic Surgery - MEDICAID - VIRGINIA
| 2/3/2026 |
| 5/27/2026 |
RECELL Autologous Cell Harvesting Device - MEDICAID - VIRGINIA
| 2/3/2026 |
| 5/27/2026 |
Skin and Tissue Substitutes - MEDICAID - VIRGINIA
| 2/3/2026 |
| 5/27/2026 |
Temporomandibular Disorders - MEDICAID - VIRGINIA
| 2/3/2026 |
| 5/25/2026 |
Injections for Chronic Pain Conditions - MEDICAID - SOUTH CAROLINA
| 2/3/2026 |
| 5/25/2026 |
Obstructive Sleep Apnea Interventional Therapy - MEDICAID - SOUTH CAROLINA
| 2/3/2026 |
| 5/25/2026 |
Orthognathic Surgery - MEDICAID - SOUTH CAROLINA
| 2/3/2026 |
| 5/25/2026 |
Skin and Tissue Substitutes - MEDICAID - SOUTH CAROLINA
| 2/3/2026 |
| 5/25/2026 |
Temporomandibular Disorders - MEDICAID - SOUTH CAROLINA
| 2/3/2026 |
| 5/22/2026 |
Injections for Chronic Pain Conditions - MEDICAID - ILLINOIS
| 2/3/2026 |
| 5/22/2026 |
Injections for Chronic Pain Conditions - MEDICAID - MICHIGAN
| 2/3/2026 |
| 5/22/2026 |
Obstructive Sleep Apnea Interventional Therapy - MEDICAID - ILLINOIS
| 2/3/2026 |
| 5/22/2026 |
Obstructive Sleep Apnea Interventional Therapy - MEDICAID - MICHIGAN
| 2/3/2026 |
| 5/22/2026 |
Orthognathic Surgery - MEDICAID - MICHIGAN
| 2/3/2026 |
| 5/22/2026 |
Skin and Tissue Substitutes - MEDICAID - ILLINOIS
| 2/3/2026 |
| 5/22/2026 |
Temporomandibular Disorders - MEDICAID - MICHIGAN
| 2/3/2026 |
| 5/20/2026 |
Obstructive Sleep Apnea Interventional Therapy - MEDICAID - INDIANA
| 2/3/2026 |
| 5/20/2026 |
RECELL Autologous Cell Harvesting Device - MEDICAID - INDIANA
| 2/3/2026 |
| 5/20/2026 |
Skin and Tissue Substitutes - MEDICAID - INDIANA
| 2/3/2026 |
| 5/18/2026 |
Bariatric Surgery - MEDICAID - LOUISIANA
| 9/2/2025 |
| 5/18/2026 |
Breast Surgery - MEDICAID - LOUISIANA
| 9/2/2025 |
| 5/18/2026 |
Continuous Subcutaneous Insulin External Infusion Pump - MEDICAID - LOUISIANA
| 9/2/2025 |
| 5/18/2026 |
Genetic Testing for Breast and Ovarian Cancer FAP and Lynch Syndrome - MEDICAID - LOUISIANA
| 9/2/2025 |
| 5/18/2026 |
Hearing Aids - MEDICAID - LOUISIANA
| 9/2/2025 |
| 5/18/2026 |
High Frequency Chest Wall Oscillation Devices - MEDICAID - LOUISIANA
| 10/7/2025 |
| 5/18/2026 |
Inhaled Nitric Oxide - MEDICAID - LOUISIANA
| 9/2/2025 |
| 5/18/2026 |
Osteogenic Bone Growth Stimulators - MEDICAID - LOUISIANA
| 10/7/2025 |
| 5/18/2026 |
Transcranial Magnetic Stimulation (TMS) - MEDICAID - LOUISIANA
| 10/7/2025 |
| 5/15/2026 |
Inhaled Nitric Oxide - MEDICAID - KENTUCKY
| 9/2/2025 |
| 5/13/2026 |
Breast Procedures - MEDICAID - INDIANA
| 8/5/2025 |
| 5/13/2026 |
Cardiac Devices - MEDICAID - KENTUCKY
| 7/1/2025 |
| 5/13/2026 |
Gene Expression Profiling for Cancer Indications - MEDICAID - INDIANA
| 12/2/2025 |
| 5/13/2026 |
Home Health - MEDICAID - INDIANA
| 10/7/2025 |
| 5/13/2026 |
Prosthetics - MEDICAID - INDIANA
| 10/7/2025 |
| 5/12/2026 |
Spinal Cord Stimulators - Medicare Advantage
| 5/12/2026 |
| 5/8/2026 |
Eyebrow & Eyelid Repair - MEDICAID - LOUISIANA
| 8/5/2025 |
| 5/8/2026 |
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - LOUISIANA
| 8/5/2025 |
| 5/1/2026 |
Advanced Imaging of the Spine - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Autonomic Nerve Function Testing - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Cardiovascular Nuclear Imaging and Stress Testing - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Cranial Electrical Stimulation - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Dysphagia Imaging Evaluation - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Gene Expression Profiling for Cancer Indications - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Knee Arthroscopy - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Microwave Thermotherapy - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Multi-Function Oscillation Lung Expansion Therapy - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Multianalyte Assays with Algorithmic Analyses for Cancer Indications - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Peripheral Artery Revascularization of the Lower Extremities - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Power Wheelchair Accessories - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Prostate Radiation Therapy - Hypofractionation - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Ryoncil (remestemcel-L-rknd) - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Single Gene and Molecular Biomarker Testing for Solid Tumors - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Tecelra (afamitresgene autoleucel) - Medicare Advantage
| 4/14/2026 |
| 5/1/2026 |
Upper and Lower Extremity Computed Tomography Angiography (CTA) - Medicare Advantage
| 1/13/2026 |
| 4/13/2026 |
Gene Expression Profiling for Cancer Indications - MEDICAID - OHIO
| 6/3/2025 |
| 4/10/2026 |
Breast Procedures - MEDICAID - OHIO
| 8/5/2025 |
| 4/8/2026 |
Gene Expression Profiling for Cancer Indications - MEDICAID - MICHIGAN
| 12/2/2025 |
| 4/8/2026 |
Gene Expression Profiling for Cancer Indications - MEDICAID - SOUTH CAROLINA
| 12/2/2025 |
| 4/8/2026 |
Gene Expression Profiling for Cancer Indications - MEDICAID - VIRGINIA
| 12/2/2025 |
| 4/8/2026 |
Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - INDIANA
| 8/5/2025 |
| 4/6/2026 |
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - FLORIDA
| 11/4/2025 |
| 4/6/2026 |
Superficial Radiation Treatment - MEDICAID - FLORIDA
| 11/4/2025 |
| 4/1/2026 |
Artificial Intervertebral Disc Replacement - Medicare Advantage
| 3/10/2026 |
| 4/1/2026 |
Cardiac Magnetic Resonance Imaging (MRI) - Medicare Advantage
| 3/10/2026 |
| 4/1/2026 |
Computer Assisted Surgical Navigation for Musculoskeletal Procedures - Medicare Advantage
| 3/10/2026 |
| 4/1/2026 |
Facility Based Sleep Studies - Medicare Advantage
| 3/10/2026 |
| 4/1/2026 |
Genetic Testing for Hereditary Colorectal and Uterine Cancer - Medicare Advantage
| 3/10/2026 |
| 4/1/2026 |
Hyperthermia and Ultrasound-Based Ablative Cancer Treatments - Medicare Advantage
| 3/10/2026 |
| 4/1/2026 |
Low Frequency, Non-Contact, Non-Thermal Ultrasound for Wound Care - Medicare Advantage
| 3/10/2026 |
| 4/1/2026 |
Nerve Stimulation for Urinary Incontinence - Medicare Advantage
| 3/10/2026 |
| 4/1/2026 |
Sinonasal and Eustachian Tube Surgical Procedures - Medicare Advantage
| 3/10/2026 |
| 4/1/2026 |
Uterine Fibroid Surgical Treatments - Medicare Advantage
| 3/10/2026 |
| 4/1/2026 |
Varicose Vein Treatments - Medicare Advantage
| 3/10/2026 |
| 3/18/2026 |
Cardiac Devices - MEDICAID - INDIANA
| 7/1/2025 |
| 3/18/2026 |
Home Health - MEDICAID - LOUISIANA
| 7/1/2025 |
| 3/16/2026 |
Hip Arthroplasty - Medicare Advantage
| 10/14/2025 |
| 3/16/2026 |
Knee Arthroplasty - Medicare Advantage
| 10/14/2025 |
| 3/9/2026 |
Cardiac Devices - MEDICAID - VIRGINIA
| 11/4/2025 |
| 3/9/2026 |
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - SOUTH CAROLINA
| 11/4/2025 |
| 3/9/2026 |
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - VIRGINIA
| 11/4/2025 |
| 3/9/2026 |
Superficial Radiation Therapy - MEDICAID - MICHIGAN
| 11/4/2025 |
| 3/9/2026 |
Superficial Radiation Therapy - MEDICAID - SOUTH CAROLINA
| 11/4/2025 |
| 3/9/2026 |
Superficial Radiation Therapy - MEDICAID - VIRGINIA
| 11/4/2025 |
| 3/2/2026 |
Brachytherapy - Medicare Advantage
| 2/10/2026 |
| 3/2/2026 |
Cosmetic and Reconstructive Surgery - Medicare Advantage
| 2/10/2026 |
| 3/2/2026 |
Diagnostic and Therapeutic Esophagogastroduodenoscopy or Esophagoscopy - Medicare Advantage
| 2/10/2026 |
| 3/2/2026 |
Gastric Pacing and Gastric Electrical Stimulation - Medicare Advantage
| 2/10/2026 |
| 3/2/2026 |
Intensity Modulated Radiation Therapy - Medicare Advantage
| 2/10/2026 |
| 3/2/2026 |
Kebilidi (eladocagene exuparvovec-tneq) - Medicare Advantage
| 2/10/2026 |
| 3/2/2026 |
Pneumatic Compression Devices - Medicare Advantage
| 2/10/2026 |
| 3/2/2026 |
Proton Beam, Neutron Beam and Carbon Ion Radiation Therapy - Medicare Advantage
| 2/10/2026 |
| 3/2/2026 |
Treatment of Achalasia, Gastroesophageal Reflux Disease and Hiatal Hernia - Medicare Advantage
| 2/10/2026 |
| 2/20/2026 |
Prosthetics - MEDICAID - FLORIDA
| 10/7/2025 |
| 2/11/2026 |
Applied Behavioral Analysis - MEDICAID - LOUISIANA
| 5/6/2025 |
| 2/11/2026 |
Prosthetics - MEDICAID - MICHIGAN
| 10/7/2025 |
| 2/11/2026 |
Prosthetics - MEDICAID - SOUTH CAROLINA
| 10/7/2025 |
| 2/11/2026 |
Prosthetics - MEDICAID - VIRGINIA
| 10/7/2025 |
| 2/2/2026 |
Bariatric Surgery - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Bone Graft Substitutes - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Capsule Endoscopy - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Cardiac Computed Tomography (CT) - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Cardiac Pacemakers - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Elective Aorta and Iliac Artery Aneurysm Repair - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Gene Therapy Treatments for Sickle Cell Disease - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Genetic and Coagulation Testing for Noncancer Blood Disorders - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Left Atrial Appendage and Cardiac Structural Defect Closure - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Orthognathic Surgery - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Percutaneous Vertebroplasty, Kyphoplasty, Sacroplasty - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Psychological and Neuropsychological Testing - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
RECELL Autologous Cell Harvesting Device - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Skysona (elivaldogene autotemcel) - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Spinal Decompression Surgery - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Temporomandibular Disorders - Medicare Advantage
| 1/13/2026 |
| 2/2/2026 |
Transcatheter Peripheral Vascular Stents - Chest, Abdomen and Pelvis - Medicare Advantage
| 1/13/2026 |
| 1/30/2026 |
Crisis Intervention-Follow Up - MEDICAID - LOUISIANA
| 7/1/2025 |
| 1/30/2026 |
Cutaneous Vascular Lesion Removal - MEDICAID - INDIANA
| 9/2/2025 |
| 1/30/2026 |
Individual Placement and Support - MEDICAID - LOUISIANA
| 6/3/2025 |
| 1/30/2026 |
Inhaled Nitric Oxide - MEDICAID - OHIO
| 9/2/2025 |
| 1/30/2026 |
Inhaled Nitric Oxide - MEDICAID - OKLAHOMA
| 9/2/2025 |
| 1/16/2026 |
Hospital Bed - MEDICAID - LOUISIANA
| 7/1/2025 |
| 1/16/2026 |
Inhaled Nitric Oxide - MEDICAID - FLORIDA
| 9/2/2025 |
| 1/13/2026 |
Gene Therapy Treatments for Sickle Cell Disease - MEDICAID - KENTUCKY
| 11/17/2025 |
| 1/9/2026 |
Breast Procedures - MEDICAID - OKLAHOMA
| 8/5/2025 |
| 1/7/2026 |
Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - OHIO
| 8/5/2025 |
| 1/7/2026 |
Inhaled Nitric Oxide - MEDICAID - VIRGINIA
| 9/2/2025 |
| 1/7/2026 |
Prosthetics - MEDICAID - OKLAHOMA
| 8/5/2025 |
| 1/2/2026 |
Brain Functional Magnetic Resonance Imaging (fMRI) - Medicare Advantage
| 12/9/2025 |
| 1/2/2026 |
Carotid Revascularization - Medicare Advantage
| 12/9/2025 |
| 1/2/2026 |
Hip Arthroscopy - Medicare Advantage
| 12/9/2025 |
| 1/2/2026 |
Magnetic Resonance Angiography (MRA) of the Chest, Abdomen and Pelvis - Medicare Advantage
| 12/9/2025 |
| 1/1/2026 |
Cardiac Devices - MEDICAID - MICHIGAN
| 7/1/2025 |
| 1/1/2026 |
Inhaled Nitric Oxide - MEDICAID - MICHIGAN
| 9/2/2025 |
| 12/15/2025 |
Breast Procedures - MEDICAID - FLORIDA
| 8/5/2025 |
| 12/15/2025 |
Eyebrow and Eyelid Repair - MEDICAID - FLORIDA
| 8/5/2025 |
| 12/8/2025 |
23 Hour Behavioral Health Observation - In Lieu of Service - MEDICAID - LOUISIANA
| 10/1/2024 |
| 12/3/2025 |
Breast Procedures - MEDICAID - VIRGINIA
| 8/5/2025 |
| 12/3/2025 |
Cardiac Devices - MEDICAID - OHIO
| 7/1/2025 |
| 12/3/2025 |
Eyebrow and Eyelid Repair - MEDICAID - VIRGINIA
| 8/5/2025 |
| 12/3/2025 |
Mobility Assistive Devices (Wheelchairs) - MEDICAID - VIRGINIA
| 8/5/2025 |
| 12/1/2025 |
Code Compendium (Musculoskeletal and Neurologic) - Medicare Advantage
| 11/11/2025 |
| 12/1/2025 |
Gene Therapy Treatments for Beta Thalassemia - Medicare Advantage
| 11/11/2025 |
| 12/1/2025 |
Genetic Testing for Hereditary Ataxias - Medicare Advantage
| 11/11/2025 |
| 12/1/2025 |
Hematopoietic Stem Cell Transplantation - Medicare Advantage
| 11/11/2025 |
| 12/1/2025 |
Lung Biopsy and Resection - Medicare Advantage
| 11/11/2025 |
| 12/1/2025 |
Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - KENTUCKY
| 5/6/2025 |
| 12/1/2025 |
Nerve Stimulation for Fecal Incontinence - Medicare Advantage
| 11/11/2025 |
| 12/1/2025 |
Orthotics - MEDICAID - KENTUCKY
| 6/3/2025 |
| 12/1/2025 |
Special Stains - Medicare Advantage
| 11/11/2025 |
| 11/12/2025 |
Genetic Testing for Diagnosis of Inherited Conditions - MEDICAID - KENTUCKY
| 5/6/2025 |
| 11/12/2025 |
Molecular Biomarker Testing for Noncancer Indications - MEDICAID - KENTUCKY
| 5/6/2025 |
| 11/12/2025 |
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - KENTUCKY
| 5/6/2025 |
| 11/12/2025 |
Skin and Tissue Substitutes - MEDICAID - LOUISIANA
| 2/4/2025 |
| 11/5/2025 |
Orthotics - MEDICAID - FLORIDA
| 6/3/2025 |
| 11/3/2025 |
Brain Stimulation Treatments - Medicare Advantage
| 10/14/2025 |
| 11/3/2025 |
Cold and Heat Therapy Devices - Medicare Advantage
| 10/14/2025 |
| 11/3/2025 |
Immersion Therapy Mattress-Bed - Medicare Advantage
| 10/14/2025 |
| 11/3/2025 |
Inpatient and Long Term Acute Care Hospital Services - Medicare Advantage
| 10/14/2025 |
| 11/3/2025 |
Interspinous Process Decompression Spacers - Medicare Advantage
| 10/14/2025 |
| 11/3/2025 |
Multiplex Pathogen Identification Panels for Infectious Disease - Medicare Advantage
| 10/14/2025 |
| 10/7/2025 |
Prosthetics - MEDICAID - KENTUCKY
| 2/4/2025 |
| 10/1/2025 |
Molecular Biomarkers for Prostate Cancer Risk Stratification - Medicare Advantage
| 9/9/2025 |
| 10/1/2025 |
Rethymic (allogenic processed thymus tissue - agdc) - Medicare Advantage
| 9/9/2025 |
| 10/1/2025 |
Rheumatoid Arthritis: Biologic Markers and Pharmacologic Assessment - Medicare Advantage
| 9/9/2025 |
| 9/6/2025 |
Inhaled Nitric Oxide - MEDICAID - SOUTH CAROLINA
| 9/2/2025 |
| 9/3/2025 |
Breast Procedures - MEDICAID - SOUTH CAROLINA
| 8/5/2025 |
| 9/3/2025 |
Genomic and Molecular Biomarker Testing for Cancer - MEDICAID - SOUTH CAROLINA
| 8/5/2025 |
| 7/8/2025 |
Cardiac Devices - MEDICAID - SOUTH CAROLINA
| 7/1/2025 |
| 7/1/2025 |
Doula Services - MEDICAID - VIRGINIA
| 7/1/2025 |
| 7/1/2025 |
Orthotics - MEDICAID - VIRGINIA
| 6/3/2025 |
| 6/6/2025 |
Hospital Based Care Coordination of Pregnant Members with Substance Use Disorder - In Lieu of Service - MEDICAID - LOUISIANA
| 10/1/2024 |
| 6/3/2025 |
Orthotics - MEDICAID - SOUTH CAROLINA
| 6/3/2025 |
| 4/11/2025 |
Wheelchair, Wheelchair Repairs, Standing Frame, and Patient Lift - MEDICAID - LOUISIANA
| 10/14/2024 |
| 1/24/2025 |
Outpatient Lactation Support Provider- In Lieu of Services (ILOS) - MEDICAID - LOUISIANA
| 10/1/2024 |
| 2/16/2024 |
Rapid Whole Genome Sequencing (rWGS) of Critically Ill Infants - MEDICAID - LOUISIANA
| 10/10/2024 |
| 11/25/2023 |
Air Ambulance Transportation (AAT) - MEDICAID - LOUISIANA
| 10/16/2024 |
| 2/24/2023 |
Assertive Community Treatment (ACT/FACT) - MEDICAID - LOUISIANA
| 5/26/2023 |
| 1/1/2023 |
Cochlear Implant - MEDICAID - LOUISIANA
| 10/1/2024 |
| 1/1/2023 |
Community Psychiatric Support and Treatment (CPST) and Psychosocial Rehabilitation (PSR) - MEDICAID - LOUISIANA
| 5/15/2023 |
| 1/1/2023 |
Crisis Stabilization for Children and Adolescents - MEDICAID - LOUISIANA
| 1/15/2025 |