Coverage policy updates

Policy changes Backwork has recorded, newest first. The most recent change on record is from October 24, 2026. Changes appear here after Backwork reviews and applies a refresh, so this page can trail the payers’ own sites.

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

Recorded changes

86,510 on record

Recorded policy changes, newest first
Recorded	Payer	Policy	Change
May 8, 2026	Carelon Medical Benefits Management	Spine SurgeryClinical Guideline · CARELON-spine-surgery-2024-10-20-for-anthem-bcbs-ohio-medicaid	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Small Joint SurgeryClinical Guideline · CARELON-SMALL-JOINT-SURGERY	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Site of Care for Surgical ProceduresClinical Guideline · CARELON-SITE-OF-CARE-FOR-SURGICAL-PROCEDURES	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Sacroiliac Joint FusionClinical Guideline · CARELON-sacroiliac-joint-fusion-2025-11-15	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Sacroiliac Joint FusionClinical Guideline · CARELON-sacroiliac-joint-fusion-2024-10-20-updated-2025-01-01	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Level of Care for Surgical ProceduresClinical Guideline · CARELON-LEVEL-OF-CARE-FOR-SURGICAL-PROCEDURES	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Joint SurgeryClinical Guideline · CARELON-JOINT-SURGERY	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Joint Surgery [for Anthem BCBS Ohio Medicaid]Clinical Guideline · CARELON-JOINT-SURGERY-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Interventional Pain ManagementClinical Guideline · CARELON-interventional-pain-management-2025-07-26	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Interventional Pain ManagementClinical Guideline · CARELON-interventional-pain-management-2024-06-30-for-ohio-medicaid	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Interventional Pain ManagementClinical Guideline · CARELON-interventional-pain-management-2024-01-01	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Sleep Disorder ManagementClinical Guideline · CARELON-sleep-disorder-management-2025-11-15-uc	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Sleep Disorder ManagementClinical Guideline · CARELON-sleep-disorder-management-2024-10-20-updated-2025-07-01-for-anthem-bcbs-ohio-medicaid-and-regence-only-deferred-to-2025-12-01	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Wearable Cardioverter Defibrillators [for Wellpoint Massachusetts]Clinical Guideline · CARELON-WEARABLE-CARDIOVERTER-DEFIBRILLATORS-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Vascular Embolization and Occlusion ProceduresClinical Guideline · CARELON-VASCULAR-EMBOLIZATION-OCCLUSION	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Treatment of Varicose Veins and Superficial Venous InsufficiencyClinical Guideline · CARELON-TREATMENT-OF-VARICOSE-VEINS-AND-SUPERFICIAL-VENOUS-INSUFFICIENCY	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Transcatheter Ablation for Management of Supraventricular and Ventricular Arrhythmias [for Wellpoint Massachusetts]Clinical Guideline · CARELON-TRANSCATHETER-ABLATION-FOR-SUPRAVENTRICULAR-AND-VENTRICULAR-ARRHYTHMIAS	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Transcatheter Ablation for Management of Atrial Fibrillation [for Wellpoint Massachusetts]Clinical Guideline · CARELON-TRANSCATHETER-ABLATION-FOR-MANAGEMENT-OF-ATRIAL-FIBRILLATION	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Permanent Implantable Pacemakers [for Wellpoint Massachusetts]Clinical Guideline · CARELON-PERMANENT-IMPLANTABLE-PACEMAKERS	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Percutaneous Coronary Intervention [for Wellpoint Massachusetts]Clinical Guideline · CARELON-PERCUTANEOUS-CORONARY-INTERVENTION-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Implantable Cardioverter DefibrillatorsClinical Guideline · CARELON-implantable-cardioverter-defibrillators-2024-11-17-updated-2026-01-01	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Endovascular RevascularizationClinical Guideline · CARELON-ENDOVASCULAR-REVASCULARIZATION	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Electrophysiological StudiesClinical Guideline · CARELON-ELECTROPHYSIOLOGICAL-STUDIES	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Dialysis Access EvaluationsClinical Guideline · CARELON-DIALYSIS-ACCESS-EVALUATIONS	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Diagnostic Coronary Angiography [for Wellpoint Massachusetts]Clinical Guideline · CARELON-DIAGNOSTIC-CORONARY-ANGIOGRAPHY-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Diagnostic Coronary AngiographyClinical Guideline · CARELON-diagnostic-coronary-angiography-2023-04-01-updated-2024-11-17-for-anthem-bcbs-ohio-medicaid	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Catheter-Based Closure of Patent Foramen OvaleClinical Guideline · CARELON-CATHETER-BASED-CLOSURE-OF-PATENT-FORAMEN-OVALE	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Cardiac Resynchronization Therapy [for WellPoint Massachusetts]Clinical Guideline · CARELON-CARDIAC-RESYNCHRONIZATION-THERAPY	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Ambulatory Cardiac Rhythm MonitoringClinical Guideline · CARELON-AMBULATORY-CARDIAC-RHYTHM-MONITORING	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Vascular Imaging [for Wellpoint Massachusetts]Clinical Guideline · CARELON-VASCULAR-IMAGING	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Vascular ImagingClinical Guideline · CARELON-vascular-imaging-2024-10-20	Codes changed
May 8, 2026	Carelon Medical Benefits Management	SPECT ImagingClinical Guideline · CARELON-SPECT-IMAGING	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Site of Care for Advanced ImagingClinical Guideline · CARELON-SITE-OF-CARE-FOR-ADVANCED-IMAGING	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Oncologic ImagingClinical Guideline · CARELON-ONCOLOGIC-IMAGING	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Oncologic Imaging [for Amerigroup Georgia Medicaid]Clinical Guideline · CARELON-ONCOLOGIC-IMAGING-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Nuclear Medicine Imaging [for Wellpoint Massachusetts]Clinical Guideline · CARELON-NUCLEAR-MEDICINE-IMAGING-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the Spine [for Wellpoint Massachusetts]Clinical Guideline · CARELON-IMAGING-OF-THE-SPINE-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the SpineClinical Guideline · CARELON-IMAGING-OF-THE-SPINE	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the Heart [for Wellpoint Massachusetts]Clinical Guideline · CARELON-IMAGING-OF-THE-HEART-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the HeartClinical Guideline · CARELON-imaging-of-the-heart-2024-10-20-for-anthem-bcbs-ohio-medicaid	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the Head and NeckClinical Guideline · CARELON-IMAGING-OF-THE-HEAD-AND-NECK	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the Head and Neck [for Amerigroup Georgia Medicaid]Clinical Guideline · CARELON-IMAGING-OF-THE-HEAD-AND-NECK-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the Extremities [for Wellpoint Massachusetts]Clinical Guideline · CARELON-IMAGING-OF-THE-EXTREMITIES-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the ExtremitiesClinical Guideline · CARELON-IMAGING-OF-THE-EXTREMITIES	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the ChestClinical Guideline · CARELON-IMAGING-OF-THE-CHEST	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the Chest [for Amerigroup Georgia Medicaid]Clinical Guideline · CARELON-IMAGING-OF-THE-CHEST-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the Brain [for Wellpoint Massachusetts]Clinical Guideline · CARELON-IMAGING-OF-THE-BRAIN-SUPERSEDED	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the BrainClinical Guideline · CARELON-IMAGING-OF-THE-BRAIN	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the Abdomen and PelvisClinical Guideline · CARELON-IMAGING-OF-THE-ABDOMEN-AND-PELVIS	Codes changed
May 8, 2026	Carelon Medical Benefits Management	Imaging of the Abdomen and Pelvis [for Amerigroup Georgia Medicaid]Clinical Guideline · CARELON-IMAGING-OF-THE-ABDOMEN-AND-PELVIS-SUPERSEDED	Codes changed

Recorded

Payer

Policy

Change

May 8, 2026