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.
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Please note: Policies are subject to change. If you can't find a policy for a specific service, please always refer to the following policies:
- Genetic Testing Services
- Prior Authorization of Cardiology and Radiology Services
- Non Reimbursable Health Service Codes
- Prior Authorization via Web-Based Tool for Durable Medical Equipment (DME)
- Prior Authorization of Drugs
- Prior Authorization via Web-Based Tool for Procedures
- Telemedicine/Telephone Services for Commercial Products - Effective 8/3/2022
- Telemedicine/Telephone Services for Medicare Advantage Plans during the Public Health Emergency (PHE) - Effective 8/3/2022
- Total Joint Arthroplasty – Hip and Knee
- TEMPORARY Cost Share Waiver for Treatment of Confirmed Cases of Covid-19
- Prior Authorization of Spinal Procedures - Effective 2/01/2023