Medical and Payment Policies
Draft Medical and Payment Policies
Maternal Serum Biomarkers for Prediction of Adverse Obstetric Outcomes, Effective 7/1/2025
Medical
Magnetic Capsule Endoscopy
Magnetic Esophageal Sphincter Augmentation to Treat Gastroesophageal Reflux Disease
Manipulation Under Anesthesia
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy
Mastectomy Treatment, Breast Reconstruction and Hospital Stays Mandates
Measurement of Exhaled Nitric Oxide and Exhaled Breath Condensate in the Diagnosis and Management of Respiratory Disorders
Measurement of Lipoprotein-Associated Phospholipase A2 in the Assessment of Cardiovascular Risk, Archived Effective 12/1/2024
Measurement of Ocular Blood Flow for Glaucoma
Medical Necessity
Meniscal Allografts and Other Meniscal Implants
Mental Illness and Substance Use Disorders Mandate
Microvolt T-Wave Alternans Testing
Microvolt T-Wave Alternans Testing, Effective 8/1/2025
Minimally Invasive Coronary Artery Bypass Graft Surgery
Monitored Anesthesia Care for Gastrointestinal Endoscopic Procedures
Multicancer Early Detection
Multimarker Serum Testing Related to Ovarian Cancer
Multitarget Polymerase Chain Reaction Testing for Diagnosis of Bacterial Vaginosis
Multitarget Polymerase Chain Reaction Testing for Diagnosis of Bacterial Vaginosis, Effective 5/1/2025
Myoelectric Prosthetic and Orthotic Components for the Upper Limb (formerly Myoelectric Controlled Upper-Limb Orthoses)
Payment
Mammogram and Pap Smears Mandate effective 1/1/2024
Mammograms and Pap Smears Mandate
Maximum Units
Medical Records Standards
Medical Supply Wastage
Medicare Advantage Plans Laboratory Network Hospital Outpatient Allowable Test Listing
Medicare Advantage Plans Laboratory Network Hospital/Physician/Urgent Care Allowable Test Listing
Medicare Advantage Plans National and Local Coverage Determinations
Medicare Diabetes Prevention Program (MDPP)
Modifier 22 Guidelines
Modifier 59, XE, XP, XS, XU Guidelines
Multi-Function Home Ventilators
Prior Authorization