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News & Announcements10/01/2026 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products10/1/2026
News & Announcements10/01/2026 updates to the Commercial Experimental/Investigational Services policy10/1/2026
NotificationsBundled Procedure Codes00.01.52ad10/1/2026 2:00 PM11/2/202610/1/2026Coverage and/or Reimbursement Position
NotificationsTrigger Point Injections11.14.02t10/1/2026 11:00 AM1/1/202710/5/2026Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update10/5/2026
NotificationsTeplizumab-mzwv (Tzield)08.01.99c9/4/2026 10:00 AM12/7/202610/9/2026Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update10/9/2026
New PoliciesIntraosseous Basivertebral Nerve Ablation11.15.2510/1/202610/1/2026This is a New Policy.
Updated PoliciesBundled Procedure Codes00.01.52ac7/1/2026 2:00 PM10/1/202610/1/2026Coverage and/or Reimbursement Position
Updated PoliciesBioengineered Skin Substitutes11.08.20at7/2/2026 2:00 PM10/1/202610/1/2026Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesRisankizumab-rzaa (Skyrizi®) for Intravenous Use 08.01.95d10/5/202610/5/2026Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Updated PoliciesNadofaragene Firadenovec-vncg (Adstiladrin®)08.02.11c10/5/202610/5/2026Coverage and/or Reimbursement Position;Medical Necessity Criteria
Updated PoliciesEmapalumab-lzsg (Gamifant®)08.01.54e10/5/202610/5/2026Medical Necessity Criteria;Medical Coding
Updated PoliciesSacituzumab govitecan-hziy (Trodelvy™)08.01.60h10/5/202610/5/2026Medical Necessity Criteria;Medical Coding
Updated PoliciesColorectal Cancer Screening11.03.12w7/1/202610/5/2026Coverage and/or Reimbursement Position;Medical Coding
Updated PoliciesAbatacept (Orencia®) for Injection for Intravenous Use08.00.62s10/5/202610/5/2026Medical Necessity Criteria
Updated PoliciesDenosumab (Prolia®, Xgeva®) and related biosimilars, and Romosozumab-aqqg (Evenity®) 08.00.94x10/1/202610/5/2026Medical Necessity Criteria
Updated PoliciesInclisiran (Leqvio®)08.01.91b10/12/202610/12/2026Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Reissue PoliciesNatalizumab (Tysabri®) and Related Biosimilars08.00.64i10/1/20259/30/202610/1/2026
Reissue PoliciesHyperthermic Intraperitoneal Chemotherapy for Select Intra-abdominal and Pelvic Malignancies11.00.13k6/16/20259/30/202610/1/2026
Reissue PoliciesUblituximab-xiiy (Briumvi®) for intravenous use08.02.02b10/1/20259/30/202610/1/2026
Reissue PoliciesHigh-Frequency Chest Wall Oscillation Devices05.00.14s11/17/20259/30/202610/1/2026
Reissue PoliciesRevakinagene taroretcel-lwey (Encelto®)08.02.4412/29/20259/30/202610/1/2026
Reissue PoliciesIntravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®)08.01.80e1/1/20269/30/202610/1/2026
Coding UpdateGender-Affirming Interventions11.09.02t10/1/202610/1/2026
Coding UpdateInsertion of Implantable Infusion Pumps11.15.03p10/1/202610/1/2026
Coding UpdateTreatment of Medical and Surgical Complications11.00.02j10/1/202610/1/2026
Coding UpdateFilgrastim (Neupogen®) and Related Biosimilars, and tbo-filgrastim (Granix®)08.01.73k10/1/202610/1/2026
Coding UpdatePrescription Digital Therapeutics and Mobile-Based Health Management Applications12.00.05g10/1/202610/1/2026
Coding UpdateHematopoietic Stem Cell Transplantation11.07.01ad10/1/202610/1/2026
Coding UpdateAnkle-Foot/Knee-Ankle-Foot Orthosis05.00.39x10/1/202610/1/2026
Coding UpdatePreventive Care Services00.06.02ba10/1/202610/1/2026
Coding UpdateAutomatic External Cardioverter Defibrillators (Wearable and Nonwearable)05.00.29p10/1/202610/1/2026
Coding UpdateVagus Nerve Stimulation (VNS)11.15.16x10/1/202610/1/2026
Coding UpdateProton Beam Radiation Therapy (Independence Administrators)09.00.49p10/1/202610/1/2026
Coding UpdateImplantable Cardioverter Defibrillators05.00.77g10/1/202610/1/2026
Coding UpdateAmbulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring07.02.21s10/1/202610/1/2026
Coding UpdateProphylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and Hysterectomy11.08.19t10/1/202610/1/2026
Coding UpdateReconstructive Breast Surgery and Post-Mastectomy Prostheses11.08.15ae10/1/202610/1/2026
Coding UpdateLeuprolide (Camcevi™, Camcevi ETM®​, Eligard®, Fensolvi®, Lupron Depot®)08.01.33n10/1/202610/1/2026
Coding UpdateSelf-Administered Drugs and Biologics08.00.78ay10/1/202610/1/2026
Coding UpdateCardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs10.01.01s10/1/202610/1/2026
Coding UpdateCatheter Ablation of Cardiac Arrhythmias11.02.06s10/1/202610/1/2026
Coding UpdateLaboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products00.03.07au10/1/2026
Coding UpdateCetuximab (Erbitux®)08.00.67p10/1/202610/1/2026
Coding UpdatePenpulimab-kcqx08.02.42b10/1/202610/1/2026
Coding UpdateTislelizumab-jsgr (Tevimbra®)08.02.23b10/1/202610/1/2026
Coding UpdateScar Revision11.08.25p10/1/202610/12/2026
Archived PoliciesPalivizumab (Synagis®)08.00.22q10/1/2026 9:00 AM11/1/202610/1/2026
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