Capital Blue Cross coverage policies

223 active Capital Blue Cross policies in Backwork, grouped by policy type. Each policy page shows the codes the policy lists and links to the payer’s own copy.

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

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Policies

1–50 of 223, by type and title

PayerPolicy

CAPBLUE-MP-2.376

Ablation of Peripheral Nerves to Treat Pain

Effective Mar 1, 2026

CAPBLUE-MP-2.087

Actigraphy

Effective Sep 1, 2026

CAPBLUE-MP-6.056

Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynstoses

CAPBLUE-MP-3.017

Air and Water Ambulance Services

CAPBLUE-MP-6.015

Airway Clearance Devices

CAPBLUE-MP-2.001

Allergy Testing and Immunotherapy

CAPBLUE-MP-9.055

Allogeneic Hematopoietic Cell Transplantation for Genetic Diseases and Acquired Anemias

CAPBLUE-MP-9.056

Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms

CAPBLUE-MP-1.159

Amniotic Membrane and Amniotic Fluid

CAPBLUE-MP-6.062

Ankle-Foot and Knee-Ankle-Foot Orthoses

CAPBLUE-MP-8.014