F11.250 coverage policies: Medicare and commercial payers

60 active Medicare policies list F11.250, and 1 commercial payer policy lists it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.

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Medicare policies listing F11.250

LCD · FIRST_COAST-L36393

Controlled Substance Monitoring and Drugs of Abuse Testing

J9 · Effective Oct 11, 2015

LCD · NOVITAS-JH-L35006

Controlled Substance Monitoring and Drugs of Abuse Testing

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35006

Controlled Substance Monitoring and Drugs of Abuse Testing

JL · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L37638

Health and Behavior Assessment/Intervention

JJ · Effective Jan 29, 2018

LCD · PALMETTO-JM-L37638

Health and Behavior Assessment/Intervention

JM · Effective Jan 29, 2018

LCD · NORIDIAN-JE-L37373

MRI and CT Scans of the Head and Neck

JE · Effective Oct 8, 2018

LCD · NORIDIAN-JF-L37373

MRI and CT Scans of the Head and Neck

JF · Effective Oct 8, 2018

LCD · PALMETTO-JJ-L39849

Opioid Treatment Programs

JJ · Effective Oct 20, 2024

LCD · PALMETTO-JM-L39849

Opioid Treatment Programs

JM · Effective Oct 20, 2024

LCD · CGS-J15-L34353

Commercial payer policies listing F11.250

1 policy from 1 payer

Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.

UnitedHealthcare

UnitedHealthcare policies listing F11.250, with the code’s status in each
Policy	Effective	Status of F11.250
Buprenorphine (Brixadi & Sublocade)PayerPolicy · UHC-POL-buprenorphine	Oct 1, 2026	Covered