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5/4/2026
Preventive Coverage Update of Human Papillomavirus (HPV) Screening for Commercial members (Retroactively effective 01/01/2025)
The purpose of this communication is to provide clarification of preventive coverage for human papillomavirus (HPV) screening (CPT 87626) for Commercial members (retroactively effective 01/01/2025). 
0.1Preventive Coverage Update of Human Papillomavirus (HPV) Screening for Commercial members (Retroactively effective 01/01/2025)74a2e0a5-9541-4fa0-8b43-7b7f24bd6899
4/13/2026
Expanded coverage for Arexvy, an adjuvanted respiratory syncytial virus (RSV) vaccine for Commercial Members (Retroactively effective 03/11/2026)
The purpose of this document is to communicate expanded non-routine vaccine coverage for Arexvy (retroactively effective to March 11, 2026​), an adjuvanted respiratory syncytial virus (RSV) vaccine for adult Commercial members aged 18 through 59 years who are at an increased risk for lower respiratory tract disease (LRTD) caused by RSV. ​
0.1Expanded coverage for Arexvy, an adjuvanted respiratory syncytial virus (RSV) vaccine for Commercial Members (Retroactively effective 03/11/2026)1b3ed5b0-ffd6-449e-a5d0-e600b8dfd0c3
4/1/2026
04/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
The intent of this document is to communicate the Company's Commercial coverage determinations for services identified through the Quarterly Code Update process.​ The procedure codes that represent these services will become effective on 04/01/2026, unless otherwise noted. 

For more information related to these services, please refer to specific policies when applicable.​​​​​​​​​​​​


0.104/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Productse27ab384-1f21-467b-a330-b1cc2a59f712
2/2/2026
Coverage of Meningococcal Groups A, B, C, W, and Y Vaccine (PENMENVY) for Commercial Members (Retroactively Effective 02/14/2025)

Retroactively effective to February 14, 2025, the purpose of this document is to communicate updated coverage and preventive coverage criteria for meningococcal Groups A, B, C, W, and Y vaccine (PENMENVY​) for Commercial members. ​

0.1Coverage of Meningococcal Groups A, B, C, W, and Y Vaccine (PENMENVY) for Commercial Members (Retroactively Effective 02/14/2025)7a97288b-51b1-419d-a50f-c6ac3970d27d
1/16/2026
Coverage of Immune Globulin Intravenous (IVIG) and Subcutaneous (SCIG) for Measles Post-Exposure Prophylaxis in Commercial Members
The purpose of this document is to communicate the Company's coverage position for immune globulin intravenous (IVIG) and subcutaneous (SCIG) for measles post-exposure prophylaxis in Commercial members who are severely immunocompromised or pregnant without evidence of immunity.​
0.1Coverage of Immune Globulin Intravenous (IVIG) and Subcutaneous (SCIG) for Measles Post-Exposure Prophylaxis in Commercial Members3ef527ca-2e9c-422a-bf9c-58819f3a9411
12/31/2025
01/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
The intent of this document is to communicate the Company's Commercial coverage determinations for services identified through the Quarterly Code Update process.​ The procedure codes that represent these services will become effective on 01/01/2026, unless otherwise noted. 

For more information related to these services, please refer to specific policies when applicable.​​​​​​​​​​​

0.101/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products7cf6133a-114c-4845-88ef-acb460c7e6cf
10/1/2025
10/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
The intent of this document is to communicate the Company's Commercial coverage determinations for services identified through the Quarterly Code Update process.​ The procedure codes that represent these services will become effective on 10/01/2025, unless otherwise noted. 

For more information related to these services, please refer to specific policies when applicable.​​​​​​​​​​

0.110/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products2dca8d7a-03a8-4f89-b0de-73f8f007820c
9/23/2025
Preventive Coverage of Clesrovimab (Enflonsia) for Commercial Members (Retroactively Effective 08/04/2025)
Retroactively effective to August 4, 2025, the purpose of this communication is to provide notice regarding the updated coverage and preventive coverage for clesrovimab (Enflonsia), a respiratory syncytial virus (RSV) immunization for Commercial members. 
0.1Preventive Coverage of Clesrovimab (Enflonsia) for Commercial Members (Retroactively Effective 08/04/2025)76e19c86-a4e7-4197-a7a0-c92a141bcfe3
8/26/2025
Preventive Coverage Expansion of Respiratory Syncytial Virus Vaccine for Commercial Members (Retroactively Effective June 12, 2025)

The purpose of this communication is to provide notice of updates to coverage of respiratory syncytial virus vaccine​ (RSV) for the following:

  • Retroactively effective to June 12, 2025, the medically necessary coverage for non-routine use of respiratory syncytial virus vaccine (Misspelled WordmRESVIA) was updated to include individuals 18 to 59 years of age who are at increased risk of severe RSV disease. ​ ​
  • ​Retroactively effective to June 25, 2025, the medically necessary coverage and preventive coverage criteria were updated to expand​ for the respiratory syncytial virus vaccine to c​over adults 50 to 59 years of age who are at increased risk of severe RSV disease.

0.1Preventive Coverage Expansion of Respiratory Syncytial Virus Vaccine for Commercial Members (Retroactively Effective June 12, 2025)64ddfb69-4c28-4b15-b313-2583e6294a2a
7/1/2025
07/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
The intent of this document is to communicate the Company's Commercial coverage determinations for services identified through the Quarterly Code Update process.​ The procedure codes that represent these services will become effective on 07/01/2025, unless otherwise noted.  For more information related to these services, please refer to specific policies when applicable.​​​​​​​​​

0.107/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Productsbe5a394e-21c0-4693-9d19-d3eb960a21af
4/22/2025
Clarification on the coverage of Meningococcal (Groups A, C, W, and Y) conjugate vaccines for Commercial Members (Retroactively Effective to November 18, 2024)
The purpose of this communication is to clarify the Company's coverage position for our Commercial members regarding meningococcal (Groups A, C, W, and Y) conjugate vaccines, which is retroactively effective to November 18, 2024.
0.1Clarification on the coverage of Meningococcal (Groups A, C, W, and Y) conjugate vaccines for Commercial Members (Retroactively Effective to November 18, 2024)36814671-c09d-47ea-b32d-ae74ee8b9491
4/1/2025
04/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
The intent of this document is to communicate Commercial Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 04/01/2025, unless otherwise noted. 

For more information related to these services, please refer to specific policies when applicable.​​​​​​​​

0.104/01/2025 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Productse642f42d-c0cd-4fe1-9cdf-f992a59c6e76
12/23/2024
Coverage Expansion of Respiratory Syncytial Virus Vaccine (Abrysvo) for Commercial Members (Retroactively Effective October 22, 2024)
The purpose of this communication is to provide notice regarding the updated coverage criteria for respiratory syncytial virus vaccine (Abrysvo) retroactively effective to October 22, 2024 for Commercial members. ​
0.1Coverage Expansion of Respiratory Syncytial Virus Vaccine (Abrysvo) for Commercial Members (Retroactively Effective October 22, 2024)f05014dc-7a85-4ece-817d-bc8af057c54d
7/3/2024
Pemivibart (Pemgarda) for Pre-Exposure Prophylaxis for Coronavirus Disease 2019 (COVID-19) for Commercial Members
The purpose of this document is to communicate the Company's coverage position for pemivibart (Pemgarda, Invivyd​, Inc.) for pre-exposure prophylaxis for Coronavirus disease 2019 (COVID-19) for Commercial members.  Coverage for pre-exposure prophylaxis for Coronavirus disease 2019 (COVID-19) for Commercial members​ is retroactively effective to March 22, 2024.




0.1Pemivibart (Pemgarda) for Pre-Exposure Prophylaxis for Coronavirus Disease 2019 (COVID-19) for Commercial Memberse3a12362-7045-4a36-ad6e-2c1ffce333e9
5/12/2023
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence Commercial Members (Updated May 12, 2023)

The purpose of this communication is to provide notice regarding information and procedure codes related to testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence commercial members. Additionally, this Company document identifies when coverage is provided for clinical purposes, and the nonco​vered instances such as public health surveillance and screening. 




0.1Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence Commercial Members (Updated May 12, 2023)89689bbb-5b37-4282-b90a-69b3d315792d