| News & Announcements | 04/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | | | | | | 4/1/2024 | | | 04/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | |
| Notifications | Tracheostomy Care Supplies | MA05.034a | 4/6/2024 11:00 AM | 5/6/2024 | | | 4/6/2024 | Coverage and/or Reimbursement Position;General Description, Guidelines, or Informational Update | | Tracheostomy Care Supplies | |
| Notifications | Biofeedback Therapy | MA07.010b | 3/22/2024 10:00 AM | 12/10/2023 | | | 4/23/2024 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Biofeedback Therapy | |
| Notifications | Evinacumab-dgnb (Evkeeza®) | MA08.133c | 4/24/2024 10:00 AM | 5/27/2024 | | | 4/24/2024 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Evinacumab-dgnb (Evkeeza®) | |
| New Policies | Talquetamab-tgvs (Talvey™) | MA08.166 | | 4/1/2024 | | | 4/1/2024 | This is a New Policy. | | Talquetamab-tgvs (Talvey™) | |
| New Policies | Pozelimab-bbfg (Veopoz TM) | MA08.167 | | 4/1/2024 | | | 4/1/2024 | This is a New Policy. | | Pozelimab-bbfg (Veopoz TM) | |
| New Policies | Elranatamab-bcmm (Elrexfio™) | MA08.168 | | 4/22/2024 | | | 4/22/2024 | This is a New Policy. | | Elranatamab-bcmm (Elrexfio™) | |
| Updated Policies | Leadless Pacemakers | MA05.067e | | 4/1/2024 | | | 4/1/2024 | Coverage and/or Reimbursement Position | | Leadless Pacemakers | |
| Updated Policies | Natalizumab (Tysabri®) and Related Biosimilars | MA08.029c | | 4/1/2024 | | | 4/1/2024 | Medical Necessity Criteria | | Natalizumab (Tysabri®) and Related Biosimilars | |
| Updated Policies | Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists, VEGF Biosimilars, and combination VEGF/Angiopoietin-2 (Ang-2) Inhibitors | MA08.073p | | 4/1/2024 | | | 4/1/2024 | Medical Necessity Criteria | | Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists, VEGF Biosimilars, and combination VEGF/Angiopoietin-2 (Ang-2) Inhibitors | |
| Updated Policies | eviCore Lab Management | MA06.034l | 12/2/2023 10:00 AM | 1/2/2024 | | | 4/1/2024 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | 4/1/2024 | eviCore Lab Management | |
| Updated Policies | Radiation Therapy Services | MA09.020r | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria | | Radiation Therapy Services | |
| Updated Policies | Ankle-Foot/Knee-Ankle-Foot Orthoses | MA05.010j | | 4/8/2024 | | | 4/8/2024 | General Description, Guidelines, or Informational Update | | Ankle-Foot/Knee-Ankle-Foot Orthoses | |
| Updated Policies | Knee Orthoses | MA05.013g | 3/8/2024 10:00 AM | 4/8/2024 | | | 4/8/2024 | General Description, Guidelines, or Informational Update | | Knee Orthoses | |
| Updated Policies | Mosunetuzumab-axgb (Lunsumio™) | MA08.158b | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria | | Mosunetuzumab-axgb (Lunsumio™) | |
| Updated Policies | Tisotumab vedotin-tftv (Tivdak®) | MA08.141c | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria | | Tisotumab vedotin-tftv (Tivdak®) | |
| Updated Policies | Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery | MA11.056h | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria | | Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery | |
| Updated Policies | Medicare Part B vs. Part D Crossover Drugs | MA08.007ak | | 3/17/2024 | | | 4/8/2024 | Medical Necessity Criteria;Medical Coding | | Medicare Part B vs. Part D Crossover Drugs | |
| Updated Policies | External Infusion Pumps | MA05.060b | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria | | External Infusion Pumps | |
| Updated Policies | Nivolumab and relatlimab-rmbw (Opdualag™) | MA08.152c | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Nivolumab and relatlimab-rmbw (Opdualag™) | |
| Updated Policies | Efbemalenograstim alfa-vuxw (Ryzneuta®), Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars | MA08.082l | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Efbemalenograstim alfa-vuxw (Ryzneuta®), Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars | |
| Updated Policies | Teclistamab-cqyv (Tecvayli®) | MA08.156c | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Teclistamab-cqyv (Tecvayli®) | |
| Updated Policies | Pertuzumab (Perjeta®) | MA08.063g | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria;Medical Coding | | Pertuzumab (Perjeta®) | |
| Updated Policies | Pemetrexed (Pemfexy™) | MA08.047k | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria;Medical Coding | | Pemetrexed (Pemfexy™) | |
| Updated Policies | Enfortumab vedotin-ejfv (Padcev®) | MA08.113f | | 4/8/2024 | | | 4/8/2024 | Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Enfortumab vedotin-ejfv (Padcev®) | |
| Updated Policies | High-Technology Radiology Services | MA09.002ab | | 4/14/2024 | | | 4/15/2024 | General Description, Guidelines, or Informational Update | | High-Technology Radiology Services | |
| Updated Policies | Musculoskeletal Services | MA00.047l | | 4/14/2024 | | | 4/15/2024 | Medical Necessity Criteria | | Musculoskeletal Services | |
| Updated Policies | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | MA00.010ao | | 4/1/2024 | 4/1/2024 | | 4/19/2024 | Medical Necessity Criteria | | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | |
| Updated Policies | Intraoperative Neurophysiological Monitoring (INM) | MA07.051i | 3/22/2024 11:00 AM | 12/10/2023 | 3/20/2024 | | 4/22/2024 | Medical Coding | 4/22/2024 | Intraoperative Neurophysiological Monitoring (INM) | |
| Updated Policies | Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies | MA07.050l | 3/22/2024 10:00 AM | 12/10/2023 | | | 4/22/2024 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies | |
| Updated Policies | Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids | MA11.049g | | 4/22/2024 | | | 4/22/2024 | General Description, Guidelines, or Informational Update | | Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids | |
| Updated Policies | Erythropoiesis Stimulating Agents (ESAs) | MA08.011g | | 4/22/2024 | | | 4/22/2024 | Medical Necessity Criteria;Medical Coding | | Erythropoiesis Stimulating Agents (ESAs) | |
| Updated Policies | Pressure-Reducing Support Surfaces | MA05.025f | | 4/22/2024 | | | 4/22/2024 | Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Pressure-Reducing Support Surfaces | |
| Updated Policies | Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ), Cipaglucosidase alfa-atga (Pombiliti™ ) | MA08.036g | | 4/22/2024 | | | 4/22/2024 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ), Cipaglucosidase alfa-atga (Pombiliti™ ) | |
| Updated Policies | Biofeedback Therapy | MA07.010b | 3/22/2024 10:00 AM | 12/10/2023 | | | 4/23/2024 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Biofeedback Therapy | |
| Reissue Policies | Pulse Oximetry Device in the Home Setting | MA05.042d | | 1/1/2024 | 4/3/2024 | | 4/3/2024 | | | Pulse Oximetry Device in the Home Setting | |
| Reissue Policies | Tebentafusp-tebn (Kimmtrak®) | MA08.143b | | 1/1/2024 | 4/3/2024 | | 4/3/2024 | | | Tebentafusp-tebn (Kimmtrak®) | |
| Reissue Policies | Cochlear Implantation | MA11.039e | | 1/1/2024 | 4/3/2024 | | 4/3/2024 | | | Cochlear Implantation | |
| Reissue Policies | Hospital Beds and Accessories | MA05.002f | | 1/1/2024 | 4/3/2024 | | 4/3/2024 | | | Hospital Beds and Accessories | |
| Reissue Policies | Composite Tissue Allotransplantation of the Hand(s) and Face | MA11.112 | | 1/1/2024 | 4/3/2024 | | 4/3/2024 | | | Composite Tissue Allotransplantation of the Hand(s) and Face | |
| Reissue Policies | Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf (Phesgo®) | MA08.129a | | 1/1/2024 | 4/3/2024 | | 4/3/2024 | | | Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf (Phesgo®) | |
| Reissue Policies | Chiropractic Services | MA10.004i | | 10/23/2023 | 4/17/2024 | | 4/17/2024 | | | Chiropractic Services | |
| Reissue Policies | Transcranial Magnetic Stimulation (TMS) | MA07.035d | | 1/1/2023 | 4/17/2024 | | 4/17/2024 | | | Transcranial Magnetic Stimulation (TMS) | |
| Reissue Policies | Labiaplasty | MA11.067d | | 5/14/2018 | 4/17/2024 | | 4/17/2024 | | | Labiaplasty | |
| Reissue Policies | Speech Therapy | MA10.007c | | 1/1/2020 | 4/17/2024 | | 4/17/2024 | | | Speech Therapy | |
| Reissue Policies | Ocrelizumab (Ocrevus®) | MA08.088c | | 9/17/2019 | 4/17/2024 | | 4/17/2024 | | | Ocrelizumab (Ocrevus®) | |
| Reissue Policies | Acute Care Facility Inpatient Transfers | MA12.003b | | 1/1/2023 | 4/17/2024 | | 4/17/2024 | | | Acute Care Facility Inpatient Transfers | |
| Reissue Policies | Autonomic Nervous System Testing | MA07.027f | | 10/1/2022 | 4/17/2024 | | 4/17/2024 | | | Autonomic Nervous System Testing | |
| Reissue Policies | Manual Wheelchairs | MA05.026d | | 1/1/2024 | 4/17/2024 | | 4/17/2024 | | | Manual Wheelchairs | |
| Reissue Policies | Pharmacogenetics and Metabolite Monitoring for Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) Therapy | MA06.014e | | 1/1/2024 | 4/17/2024 | | 4/17/2024 | | | Pharmacogenetics and Metabolite Monitoring for Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) Therapy | |
| Reissue Policies | Full-Body Computerized Tomography (CT) Scan Screening | MA09.012a | | 3/25/2015 | 4/17/2024 | | 4/17/2024 | | | Full-Body Computerized Tomography (CT) Scan Screening | |
| Reissue Policies | Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis | MA11.097e | | 1/1/2024 | 4/17/2024 | | 4/17/2024 | | | Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis | |
| Reissue Policies | Migraine Deactivation Surgery | MA11.098 | | 1/1/2024 | 4/17/2024 | | 4/17/2024 | | | Migraine Deactivation Surgery | |
| Reissue Policies | Alemtuzumab (Lemtrada®) | MA08.015d | | 5/4/2020 | 4/17/2024 | | 4/17/2024 | | | Alemtuzumab (Lemtrada®) | |
| Coding Update | Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults | MA05.047n | | 4/1/2024 | | | 4/1/2024 | | | Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults | |
| Coding Update | Trigger Point Injections | MA11.017i | | 4/1/2024 | | | 4/1/2024 | | | Trigger Point Injections | |
| Coding Update | Reimbursement for the Administration of Drugs, Substances, and/or Biologic Agents | MA00.051f | | 4/1/2024 | | | 4/1/2024 | | | Reimbursement for the Administration of Drugs, Substances, and/or Biologic Agents | |
| Coding Update | Wheelchair Options and Accessories | MA05.046i | | 4/1/2024 | | | 4/1/2024 | | | Wheelchair Options and Accessories | |
| Coding Update | Vedolizumab (Entyvio®) for Injection for Intravenous Use | MA08.001g | | 4/1/2024 | | | 4/1/2024 | | | Vedolizumab (Entyvio®) for Injection for Intravenous Use | |
| Coding Update | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | MA11.015y | | 4/1/2024 | | | 4/1/2024 | | | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | |
| Coding Update | Treatments for Complex Regional Pain Syndrome (CRPS) | MA08.026j | | 4/1/2024 | | | 4/1/2024 | | | Treatments for Complex Regional Pain Syndrome (CRPS) | |
| Coding Update | Abortion | MA11.010c | | 4/1/2024 | | | 4/1/2024 | | | Abortion | |
| Coding Update | Tocilizumab (Actemra®) for Intravenous Infusion and Subcutaneous Injection | MA08.045k | | 4/1/2024 | | | 4/1/2024 | | | Tocilizumab (Actemra®) for Intravenous Infusion and Subcutaneous Injection | |
| Coding Update | Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence | MA11.028j | | 4/1/2024 | | | 4/2/2024 | | | Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence | |
| Coding Update | Modifier 50: Bilateral Procedure | MA03.002q | | 4/1/2024 | | | 4/5/2024 | | | Modifier 50: Bilateral Procedure | |
| Coding Update | Modifier 62: Two Surgeons | MA00.011r | | 4/1/2024 | | | 4/5/2024 | | | Modifier 62: Two Surgeons | |
| Coding Update | Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS | MA00.015p | | 4/1/2024 | | | 4/5/2024 | | | Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS | |
| Coding Update | Complementary and Integrative Health Services | MA12.001e | | 4/1/2024 | | | 4/8/2024 | | | Complementary and Integrative Health Services | |
| Coding Update | Lower Limb Prostheses | MA05.024f | | 4/1/2024 | | | 4/12/2024 | | | Lower Limb Prostheses | |
| Coding Update | Prescription Digital Therapeutics and Mobile-Based Health Management Applications | MA12.011b | | 4/1/2024 | | | 4/12/2024 | | | Prescription Digital Therapeutics and Mobile-Based Health Management Applications | |
| Coding Update | Durable Medical Equipment (DME) | MA05.044q | | 4/1/2024 | | | 4/12/2024 | | | Durable Medical Equipment (DME) | |