Medical Policies

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Showing 201– 250 of 347 Results
Title Last Updated Category
Intraocular Lens (IOL) Implants Open a PDF 9.01.14 2025-10-22 Eyes (Ophthalmology)
Intradiscal Procedures (Effective 2026-10-15) Open a PDF 7.01.112 2026-07-15 Bone & Joints (Orthopedic)
Intradiscal Procedures Open a PDF 7.01.112 2026-07-15 Bone & Joints (Orthopedic)
Interventional Pain Management 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 7.01.122 2026-10-05 Bone & Joints (Orthopedic)
Interfacility Transfer of a Registered Inpatient Open a PDF 11.01.18 2026-03-24 Miscellaneous
Injectable Fillers for Dermal and Laryngeal Conditions Open a PDF 7.01.119 2026-09-21 Miscellaneous
Inflammatory Markers of Coronary Artery Disease Risk Open a PDF 2.02.15 2026-09-21 Lab Tests (pathology)
Implantable Cardioverter Defibrillator (ICD) Open a PDF 7.01.06 2026-03-13 Heart & Blood Vessels (Cardiovascular)
Implantable Bone Conduction Hearing Aids Open a PDF 7.01.77 2026-04-20 Ear, Nose & Throat (Otorhinolaryngology)
Implantable and Invasive Neuromodulation Systems Open a PDF 1.01.60 2026-05-27 Durable Medical Equipment & Supplies
Hyperbaric Oxygen Therapy (HBOT) Open a PDF 2.01.07 2026-07-21 Miscellaneous
Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failure (Effective 2026-10-15) Open a PDF 1.01.57 2026-07-15 Sleep Medicine
Home Birth by Certified Nurse Midwives Open a PDF 11.01.23 2025-10-22 Women's Health (Obstetrics & Gynecology)
Home Automatic External Defibrillators (AEDs) and Wearable Cardioverter Defibrillators (WCDs) Open a PDF 1.01.42 2026-06-25 Heart & Blood Vessels (Cardiovascular)
Hip Arthroplasty (Effective 2026-10-15) Open a PDF 7.01.96 2026-07-15 Bone & Joints (Orthopedic)
Hip Arthroplasty Open a PDF 7.01.96 2026-07-15 Bone & Joints (Orthopedic)
Heart Failure Management Devices Open a PDF 7.01.91 2026-03-13 Heart & Blood Vessels (Cardiovascular)
Heart & Heart/Lung Transplant Open a PDF 7.02.06 2026-07-21 Transplants
Germline Genetic Testing for Hereditary Cancers Open a PDF 2.02.60 2026-04-20 Genetic Disease (Inherited Disease)
Genetic Testing for Thoracic Aortic Aneurysms/ Dissections and Connective Tissue Related Disorders Open a PDF 2.02.61 2026-09-21 Genetic Disease (Inherited Disease)
Genetic Testing for Inherited Disorders Open a PDF 2.02.03 2025-12-23 Genetic Disease (Inherited Disease)
Genetic Testing for Cystic Fibrosis Open a PDF 2.02.17 2026-07-21 Genetic Disease (Inherited Disease)
Genetic Testing for Cardiac Ion Channelopathies Open a PDF 2.02.38 2026-05-27 Genetic Disease (Inherited Disease)
Genetic Assay of Tumor Tissue to Determine Prognosis and Treatment of Breast Cancer Open a PDF 2.02.27 2026-04-20 Genetic Disease (Inherited Disease)
Gene Expression Profiling for Cutaneous Melanoma Open a PDF 2.02.52 2025-10-22 Cancer Treatment (Oncology)
Gender Reassignment/Gender Affirming Surgery and Treatments for Medicaid Managed Care Plan (MMCP) and Health and Recovery Plan (HARP) Members Open a PDF 7.01.105 2026-03-20 Miscellaneous
Gender Affirming Surgery and Treatments for Commercial and Medicare Advantage Members Open a PDF 7.01.84 2026-05-27 Miscellaneous
Gender Affirming Behavioral Health and Medical Services Open a PDF 3.01.22 2026-08-25 Miscellaneous
Gastric Electrical Stimulation Open a PDF 7.01.64 2026-01-27 Digestive System (Gastroenterology)
Foot Orthotics Open a PDF 1.01.41 2026-07-21 Feet (Podiatry)
Focal Therapies for Prostate Cancer Treatment Open a PDF 7.01.01 2026-08-25 Urinary System (Genitourinary)
Fecal Microbiota Transplantation Open a PDF 2.01.48 2026-09-21 Digestive System (Gastroenterology)
Facet Joint Injections/ Medial Branch Blocks (Effective 2026-10-15) Open a PDF 7.01.116 2026-07-15 Bone & Joints (Orthopedic)
Facet Joint Injections/ Medial Branch Blocks Open a PDF 7.01.116 2026-07-15 Bone & Joints (Orthopedic)
Extracorporeal Shock Wave Therapy (ESWT) for Muscoloskeletal Conditions and Soft Tissue Wounds Open a PDF 2.01.31 2026-09-01 Bone & Joints (Orthopedic)
Extracorporeal Photochemotherapy/Photopheresis Open a PDF 8.01.01 2025-10-22 Skin (Dermatology)
Showing 201– 250 of 347 Results

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