| May 17, 2026 | BlueCross BlueShield of Tennessee | Abbreviated Daytime Sleep Study (e.g. PAP-NAP)PayerPolicy · BCBSTN-07e665322d | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Ranibizumab Injections, Implants and BiosimilarsPayerPolicy · BCBSOK-OTH903.041 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Radiofrequency Volumetric Tissue Reduction for Nasal ObstructionPayerPolicy · BCBSOK-SUR706.001 | Criteria changed |
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| May 17, 2026 | BlueCross BlueShield of Tennessee | Abatacept (Orencia)PayerPolicy · BCBSTN-f7a10b5737 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Radiofrequency Energy Therapy for Stress Urinary IncontinencePayerPolicy · BCBSOK-SUR710.021 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver TumorsPayerPolicy · BCBSOK-SUR701.021 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Radiofrequency Ablation (RFA) of Primary or Metastatic Liver TumorsPayerPolicy · BCBSOK-SUR709.029 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Radioembolization for Primary and Metastatic Tumors of the LiverPayerPolicy · BCBSOK-RAD601.047 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Febrile Neutropenia RiskClinical Guideline · CARELON-febrile-neutropenia-risk | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Quantitative Sensory TestingPayerPolicy · BCBSOK-MED205.030 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Quantitative Electroencephalography as a Diagnostic Aid for Attention-Deficit/Hyperactivity Disorder, Cognitive Impairment, or Autism Spectrum DisorderPayerPolicy · BCBSOK-MED205.040 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Prostatic Urethral LiftPayerPolicy · BCBSOK-SUR710.023 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | ProlotherapyPayerPolicy · BCBSOK-MED201.013 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Progenitor Cell Therapy for the Treatment of Damaged Myocardium Due to IschemiaPayerPolicy · BCBSOK-SUR703.027 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Pozelimab-bbfgPayerPolicy · BCBSOK-RX501.182 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Powered Exoskeleton for Ambulation in Patients With Lower-Limb DisabilitiesPayerPolicy · BCBSOK-DME103.008 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism ProphylaxisPayerPolicy · BCBSOK-MED202.073 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Proton Beam TherapyClinical Guideline · CARELON-PROTON-BEAM-THERAPY | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Polysomnography for Non-Respiratory Sleep DisordersPayerPolicy · BCBSOK-MED201.049 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Plugs for Anal Fistula RepairPayerPolicy · BCBSOK-SUR709.032 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Physical Therapy (PT) and Occupational Therapy (OT) ServicesPayerPolicy · BCBSOK-THE803.010 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Phrenic Nerve Stimulation for Central Sleep ApneaPayerPolicy · BCBSOK-SUR701.042 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Phototherapeutic KeratectomyPayerPolicy · BCBSOK-SUR713.023 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Photodynamic Therapy for Choroidal NeovascularizationPayerPolicy · BCBSOK-OTH903.015 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Whole Exome Sequencing and Whole Genome SequencingClinical Guideline · CARELON-whole-exome-sequencing-and-whole-genome-sequencing-2025-07-26-updated-10-01 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux (VUR)PayerPolicy · BCBSOK-SUR710.022 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Peripheral Subcutaneous Field StimulationPayerPolicy · BCBSOK-MED205.036 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Percutaneous Revascularization Procedures for Lower Extremity Peripheral Arterial DiseasePayerPolicy · BCBSOK-SUR707.034 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Somatic Tumor TestingClinical Guideline · CARELON-somatic-tumor-testing-2024-11-17-updated-2025-01-01 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial FibrillationPayerPolicy · BCBSOK-SUR701.009 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Prenatal Screening Using Cell Free DnaClinical Guideline · CARELON-prenatal-screening-using-cell-free-dna-2025-09-20 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty, and BiacuplastyPayerPolicy · BCBSOK-SUR712.023 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Percutaneous Electrical Nerve Stimulation, Percutaneous Neuromodulation Therapy, and Restorative Neurostimulation TherapyPayerPolicy · BCBSOK-MED205.032 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Predictive and Prognostic Polygenic TestingClinical Guideline · CARELON-predictive-and-prognostic-polygenic-testing-2024-10-20-updated-2026-01-01 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Percutaneous Electrical Nerve Field Stimulation for Irritable Bowel SyndromePayerPolicy · BCBSOK-MED201.055 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Pelvic Floor Stimulation as a Treatment of Urinary or Fecal IncontinencePayerPolicy · BCBSOK-DME101.037 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Pharmacogenomic TestingClinical Guideline · CARELON-pharmacogenomic-testing-2025-07-26 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | PegloticasePayerPolicy · BCBSOK-RX501.120 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Pharmacogenetic TestingClinical Guideline · CARELON-pharmacogenetic-testing-2025-11-15-updated-2026-01-01 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Patient-Specific Instrumentation (e.g., Cutting Guides) for Joint ArthroplastyPayerPolicy · BCBSOK-SUR705.037 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Outpatient Pulmonary RehabilitationPayerPolicy · BCBSOK-THE803.025 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Hereditary Cancer TestingClinical Guideline · CARELON-hereditary-cancer-testing-2025-03-23-updated-2026-01-01-2 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Orthoptics (Vergence/Accommodative Therapy), Visual Exercises or TrainingPayerPolicy · BCBSOK-OTH903.012 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Orthopedic Applications of Stem Cell Therapy (Including Allografts and Bone Substitutes Used with Autologous Bone Marrow)PayerPolicy · BCBSOK-SUR703.051 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Orthopedic Applications of Platelet-Rich PlasmaPayerPolicy · BCBSOK-RX501.101 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Orthognathic SurgeryPayerPolicy · BCBSOK-SUR705.030 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Genetic Testing for Inherited ConditionsClinical Guideline · CARELON-genetic-testing-for-inherited-conditions-2024-06-30-updated-01-20-2025 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Organ and Tissue Transplantation (General Donor and Recipient Information)PayerPolicy · BCBSOK-SUR703.001 | Criteria changed |
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| May 17, 2026 | BCBS Oklahoma | Optical Coherence Tomography of the Anterior Eye SegmentPayerPolicy · BCBSOK-OTH903.021 | Criteria changed |
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| May 17, 2026 | Carelon Medical Benefits Management | Genetic Liquid Biopsy in the Management of Cancer and Cancer SurveillanceClinical Guideline · CARELON-genetic-liquid-biopsy-in-the-management-of-cancer-and-cancer-surveillance-2025-11-15-updated-2026-01-01 | Criteria changed |
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