Look up Medical and Payment Policies
Search, view, and print our current medical coverage and payment policies. Please note this is not a complete listing. We update policies on a regular basis and they are subject to change.
Please note: Policies are subject to change. If you can't find a policy for a specific service, please always refer to the following two policies:
- Prior Authorization via Web-Based Tool for Procedures
- Prior Authorization via Web-Based Tool for Durable Medical Equipment (DME)
The policies below exclude Federal Employee Program® (FEP) products. For FEP policies, please call (401) 272-5670.