P F
May 1, 2026

Payment policy updates

Non-Reimbursable Health Service Codes Policy 2026 

  • Effective April 1, 2026 the below codes were added to the policy as NSR and are only covered for DME providers only. All lines of business professional and facility: A4318, A4479, A6548
  • NSR for all lines of business professional and facility: 

    G0681, G0682, G0683, G0684

  • Separately Reimbursed for Professional all LOB and NSR (f12) for Facility for all LOB: 

    A2040, A2041, A2042, A2043, A2044, A2045, L5992

  • CPT Code 77387 was removed from the NSR list effective January 1, 2026 for professional only and for all lines of business. 

For additional details related to this policy, please click here

 

Nutritional Counseling Medical Nutritional Therapy (MNT)

Effective January 1, 2026, we removed the unit limits for both Commercial and Medicare plans for the following codes: 

97802   Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes

97803   Medical nutrition therapy, re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes

97804   Medical nutrition therapy; group (two or more individuals), each 30 minutes

For additional details related to this policy, please click here

 

2026 Compression Garments Stockings

Effective April 1, 2026, CPT code A6548 was added to this policy and is payable to DME providers.

For additional details related to this policy, please click here