Commercial

Medical Policy

Name	MPDispTitle	MPPolicyNumber	Policy Category	Title	MPPolicyPageName	ID	MPTitle	MPPolicyNumberwithoutversion	MPNotificationIssuedDate	MPEffectiveDate
1601f15c-98e7-431c-8097-72bbc8db13e3	EvaluationandManagement(E&M)ofDiabeticPeripheralNeuropathywithLossofProtectiveSensation(LOPS)07.03.15d	07.03.15d	Medicine (07)	Evaluation and Management (E&M) of Diabetic Peripheral Neuropathy with Loss of Protective Sensation (LOPS)	1601f15c-98e7-431c-8097-72bbc8db13e3	8430	Evaluation and Management (E&M) of Diabetic Peripheral Neuropathy with Loss of Protective Sensation (LOPS)	07.03.15	5/29/2026 9:00 AM	6/24/2026
204d6e1f-bcbb-42d9-b74c-69a4b7058ad3	IntravitrealInjectionofVascularEndothelialGrowthFactor(VEGF)Antagonists,VEGFBiosimilars,andCombinationVEGF/Angiopoietin-2(Ang-2)Inhibitors08.00.74ad	08.00.74ad	Pharmacy (08)	Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists, VEGF Biosimilars, and Combination VEGF/Angiopoietin-2 (Ang-2) Inhibitors	204d6e1f-bcbb-42d9-b74c-69a4b7058ad3	8477	Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists, VEGF Biosimilars, and Combination VEGF/Angiopoietin-2 (Ang-2) Inhibitors	08.00.74	5/4/2026 3:00 PM	8/3/2026
55e7089b-0b2b-4910-8f00-7f924a4d6574	MultipleSurgeryPaymentReduction11.00.10z	11.00.10z	Surgery (11)	Multiple Surgery Payment Reduction	55e7089b-0b2b-4910-8f00-7f924a4d6574	8432	Multiple Surgery Payment Reduction	11.00.10	6/1/2026 10:00 AM	9/1/2026
1122d2ac-7f8e-4df4-aaf1-ba5d5f462d85	Tildrakizumab-asmn(Ilumya®)08.01.48c	08.01.48c	Pharmacy (08)	Tildrakizumab-asmn (Ilumya®)	1122d2ac-7f8e-4df4-aaf1-ba5d5f462d85	8462	Tildrakizumab-asmn (Ilumya®)	08.01.48	6/12/2026 1:00 PM	9/14/2026

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