Commercial
Advanced Search
  
  
  
  
  
  
  
  
  
  
  
News & AnnouncementsPreventive Coverage of Clesrovimab (Enflonsia) for Commercial Members (Retroactively Effective 08/04/2025)9/23/2025
Updated PoliciesNot Medically Necessary Services and Obsolete or Unreliable Diagnostic Tests00.01.24m9/8/20259/8/2025Coverage and/or Reimbursement Position;Medical Necessity Criteria
Updated PoliciesCochlear Implantation11.01.02s9/8/20259/8/2025Medical Necessity Criteria
Updated PoliciesIn Vivo Allergy Sensitivity Testing07.00.05j9/8/20259/8/2025Medical Necessity Criteria
Updated PoliciesElectromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies07.03.09w9/22/20259/22/2025Medical Necessity Criteria;Medical Coding
Updated PoliciesIntraoperative Neurophysiological Monitoring (INM)07.03.14s9/22/20259/22/2025Medical Necessity Criteria;Medical Coding
Updated PoliciesDaratumumab (Darzalex®), Daratumumab and Hyaluronidase-fihj (Darzalex Faspro®)08.01.29m9/22/20259/22/2025Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Reissue PoliciesSelective Photothermolysis Using Pulsed-Dye Lasers (PDL)11.08.04i7/11/20229/3/20259/3/2025
Reissue PoliciesUpper Limb Prostheses05.00.72h4/1/20259/3/20259/3/2025
Reissue PoliciesOtoplasty or Non-Surgical External Ear Molding11.01.01j9/8/20189/3/20259/3/2025
Reissue PoliciesAuricular Prostheses05.00.825/20/20249/3/20259/3/2025
Reissue PoliciesAbatacept (Orencia®) for Injection for Intravenous Use08.00.62q9/23/20249/3/20259/3/2025
Reissue PoliciesSebelipase alfa (Kanuma®)08.01.28e9/26/20229/3/20259/3/2025
Reissue PoliciesLifileucel (Amtagvi™)08.02.2210/21/20249/3/20259/3/2025
Reissue PoliciesDirect Endoscopic Necrosectomy (DEN) for the Treatment of Pancreatic Necrosis11.03.161/20/20259/3/20259/3/2025
Reissue PoliciesCatheter Ablation of Cardiac Arrhythmias11.02.06r1/1/20259/3/20259/3/2025
Reissue PoliciesBone Mineral Density (BMD) Testing09.00.04o1/2/20249/3/20259/3/2025
Reissue PoliciesNadofaragene Firadenovec-vncg (Adstiladrin®)08.02.11b10/21/20249/3/20259/3/2025
Reissue PoliciesProteomic (Protein)-Based Testing for the Evaluation of Ovarian (Adnexal) Masses Using OVA1® Test and Risk of Ovarian Malignancy Algorithm (ROMA™)06.02.43b2/1/20179/3/20259/30/2025
Archived PoliciesFetal Fibronectin Enzyme (fFN) Immunoassay06.02.04d9/5/2025 9:00 AM10/6/20259/5/2025
Archived PoliciesLaboratory-Based Vestibular Function Testing07.03.24b9/5/2025 9:00 AM10/6/20259/5/2025
Archived PoliciesSmell and Taste Dysfunction Testing07.11.01c9/5/2025 9:00 AM10/6/20259/5/2025