Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Recorded changes
82,180 on record
Recorded policy changes, newest first| Recorded | Payer | Policy | Change |
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| Sep 30, 2026 | Molina Healthcare | G2181 Colorectal Cancer Screening Prior VariancePayerPolicy · MOLINA-OH-MARKETPLACE-LAB-G2181-COLORECTAL-CANCER-SCREENING-PRIOR-VARIANCE | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2022 Biomarker Testing for Autoimmune Rheumatic DiseasePayerPolicy · MOLINA-OH-MARKETPLACE-LAB-G2022-BIOMARKER-TESTING-FOR-AUTOIMMUNE-RHEUMATIC | Retired |
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| Sep 30, 2026 | Molina Healthcare | Optum EDC Analyzer - Facility ER E&M Leveling PrepaymentPayerPolicy · MOLINA-OH-MARKETPLACE-CLINICAL-OPTUM-EDC-ANALYZER-FACILITY-ER-E-M-LEVELING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Newborn and NICUPayerPolicy · MOLINA-OH-MARKETPLACE-CLINICAL-NEWBORN-AND-NICU | Retired |
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| Sep 30, 2026 | Molina Healthcare | Hospital Routine Supplies ServicesPayerPolicy · MOLINA-OH-MARKETPLACE-CLINICAL-HOSPITAL-ROUTINE-SUPPLIES-SERVICES | Retired |
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| Sep 30, 2026 | Molina Healthcare | HospicePayerPolicy · MOLINA-OH-MARKETPLACE-CLINICAL-HOSPICE | Retired |
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| Sep 30, 2026 | Molina Healthcare | Breast Cancer Genetic Testing Tier 1 vs Tier 2PayerPolicy · MOLINA-OH-MARKETPLACE-CLINICAL-BREAST-CANCER-GENETIC-TESTING-TIER-1-VS-TIER-2 | Retired |
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| Sep 30, 2026 | Molina Healthcare | Repeat Procedure Modifiers 76 77PayerPolicy · MOLINA-OH-MARKETPLACE-REPEAT-PROCEDURE-MODIFIERS-76-77 | Retired |
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| Sep 30, 2026 | Molina Healthcare | NCCI PTP with ModifiersPayerPolicy · MOLINA-OH-MARKETPLACE-NCCI-PTP-WITH-MODIFIERS | Retired |
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| Sep 30, 2026 | Molina Healthcare | ICD-10 First Listed Diagnosis Coding PolicyPayerPolicy · MOLINA-OH-MARKETPLACE-CODING-ICD-10-FIRST-LISTED-DIAGNOSIS-CODING-POLICY | Retired |
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| Sep 30, 2026 | Molina Healthcare | Facility Bilateral or Anatomical Modifier UsePayerPolicy · MOLINA-OH-MARKETPLACE-FACILITY-BILATERAL-OR-ANATOMICAL-MODIFIER-USE | Retired |
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| Sep 30, 2026 | Molina Healthcare | Discontinued ProceduresPayerPolicy · MOLINA-OH-MARKETPLACE-DISCONTINUED-PROCEDURES | Retired |
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| Sep 30, 2026 | Molina Healthcare | Co Surgeon Team Surgeon ProfessionalPayerPolicy · MOLINA-OH-MARKETPLACE-CO-SURGEON-TEAM-SURGEON-PROFESSIONAL | Retired |
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| Sep 30, 2026 | Molina Healthcare | CMS Replacement CodesPayerPolicy · MOLINA-OH-MARKETPLACE-CMS-REPLACEMENT-CODES | Retired |
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| Sep 30, 2026 | Molina Healthcare | Advanced Beneficiary Notice ABN Modifiers GA GX GY GZPayerPolicy · MOLINA-OH-MARKETPLACE-ADVANCED-BENEFICIARY-NOTICE-ABN-MODIFIERS-GA-GX | Retired |
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| Sep 30, 2026 | Molina Healthcare | Colonoscopy and SigmoidoscopyPayerPolicy · MOLINA-NY-MEDICARE-RADIOLOGY-COLONOSCOPY-AND-SIGMOIDOSCOPY | Retired |
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| Sep 30, 2026 | Molina Healthcare | Aortography and Peripheral AngiographyPayerPolicy · MOLINA-NY-MEDICARE-RADIOLOGY-AORTOGRAPHY-AND-PERIPHERAL-ANGIOGRAPHY | Retired |
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| Sep 30, 2026 | Molina Healthcare | ESRD Billing for J0406 or J0606 with Modifier AXPayerPolicy · MOLINA-NY-MEDICARE-ESRD-ESRD-BILLING-FOR-J0406-OR-J0606-WITH-MODIFIER-AX | Retired |
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| Sep 30, 2026 | Molina Healthcare | Recovery Policy for Diagnosis CodesPayerPolicy · MOLINA-NY-MEDICARE-ADMINISTRATIVE-RECOVERY-POLICY-FOR-DIAGNOSIS-CODES | Retired |
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| Sep 30, 2026 | Molina Healthcare | Paid Amount Exceeded Billed AmountPayerPolicy · MOLINA-NY-MEDICARE-ADMINISTRATIVE-PAID-AMOUNT-EXCEEDED-BILLED-AMOUNT | Retired |
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| Sep 30, 2026 | Molina Healthcare | Multiple Procedure Payment ReductionPayerPolicy · MOLINA-NY-MEDICARE-ADMINISTRATIVE-MULTIPLE-PROCEDURE-PAYMENT-REDUCTION | Retired |
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| Sep 30, 2026 | Molina Healthcare | General Billing and Coding PolicyPayerPolicy · MOLINA-NY-MEDICARE-ADMINISTRATIVE-GENERAL-BILLING-AND-CODING-POLICY | Retired |
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| Sep 30, 2026 | Molina Healthcare | Duplicate ClaimsPayerPolicy · MOLINA-NY-MEDICARE-ADMINISTRATIVE-DUPLICATE-CLAIMS | Retired |
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| Sep 30, 2026 | Molina Healthcare | Annual Wellness Visit sooner than 11 months following Initial IPPEPayerPolicy · MOLINA-NY-MEDICARE-ADMINISTRATIVE-ANNUAL-WELLNESS-VISIT-SOONER-THAN-11-MONTHS | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2014 Vitamin B12 and Methylmalonic Acid TestingPayerPolicy · MOLINA-NY-MEDICARE-LAB-G2014-VITAMIN-B12-AND-METHYLMALONIC-ACID-TESTING | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2036 Hepatitis TestingPayerPolicy · MOLINA-NY-MEDICARE-LAB-G2036-HEPATITIS-TESTING | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2099 Intracellular Micronutrient AnalysisPayerPolicy · MOLINA-NY-MEDICARE-LAB-G2099-INTRACELLULAR-MICRONUTRIENT-ANALYSIS | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2125 Urinary Tumor Markers for Bladder CancerPayerPolicy · MOLINA-NY-MEDICARE-LAB-G2125-URINARY-TUMOR-MARKERS-FOR-BLADDER-CANCER | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2151 Serum Testing For Evidence of Mild Traumatic Brain InjuryPayerPolicy · MOLINA-NY-MEDICARE-LAB-G2151-SERUM-TESTING-FOR-EVIDENCE-OF-MILD | Retired |
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| Sep 30, 2026 | Molina Healthcare | M2057 Diagnosis of Vaginitis Prior VariancePayerPolicy · MOLINA-NY-MEDICARE-LAB-M2057-DIAGNOSIS-OF-VAGINITIS-PRIOR-VARIANCE | Retired |
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| Sep 30, 2026 | Molina Healthcare | M2116 Human Immunodeficiency Virus HIVPayerPolicy · MOLINA-NY-MEDICARE-LAB-M2116-HUMAN-IMMUNODEFICIENCY-VIRUS-HIV | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2008 Prostate Specific Antigen PSA TestingPayerPolicy · MOLINA-NY-MEDICARE-LAB-G2008-PROSTATE-SPECIFIC-ANTIGEN-PSA-TESTING | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2006 Diabetes Mellitus TestingPayerPolicy · MOLINA-NY-MEDICARE-LAB-G2006-DIABETES-MELLITUS-TESTING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Physician Office Laboratory TestingPayerPolicy · MOLINA-NY-MEDICARE-LAB-PHYSICIAN-OFFICE-LABORATORY-TESTING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Packaged and conditionally packaged lab servicesPayerPolicy · MOLINA-NY-MEDICARE-LAB-PACKAGED-AND-CONDITIONALLY-PACKAGED-LAB-SERVICES | Retired |
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| Sep 30, 2026 | Molina Healthcare | Optum EDC Analyzer - Facility ER E&M Leveling PrepaymentPayerPolicy · MOLINA-NY-MEDICARE-CLINICAL-OPTUM-EDC-ANALYZER-FACILITY-ER-E-M-LEVELING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Non-Invasive Prenatal TestingPayerPolicy · MOLINA-NY-MEDICARE-CLINICAL-NON-INVASIVE-PRENATAL-TESTING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Excludes 1 NotePayerPolicy · MOLINA-NY-MEDICARE-CLINICAL-EXCLUDES-1-NOTE | Retired |
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| Sep 30, 2026 | Molina Healthcare | Reduced Services and Discontinued ProceduresPayerPolicy · MOLINA-NY-MEDICARE-REDUCED-SERVICES-AND-DISCONTINUED-PROCEDURES | Retired |
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| Sep 30, 2026 | Molina Healthcare | PT OT ST Yearly LimitPayerPolicy · MOLINA-NY-MEDICARE-PT-OT-ST-YEARLY-LIMIT | Retired |
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| Sep 30, 2026 | Molina Healthcare | Podiatric Q ModifiersPayerPolicy · MOLINA-NY-MEDICARE-PODIATRIC-Q-MODIFIERS | Retired |
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| Sep 30, 2026 | Molina Healthcare | Multiple EM codes for the same provider same date of servicePayerPolicy · MOLINA-NY-MEDICARE-MULTIPLE-EM-CODES-FOR-THE-SAME-PROVIDER-SAME-DATE | Retired |
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| Sep 30, 2026 | Molina Healthcare | Inpatient services billed on Outpatient bill typesPayerPolicy · MOLINA-NY-MEDICARE-INPATIENT-SERVICES-BILLED-ON-OUTPATIENT-BILL-TYPES | Retired |
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| Sep 30, 2026 | Molina Healthcare | Incarceration Diagnosis CodePayerPolicy · MOLINA-NY-MEDICARE-INCARCERATION-DIAGNOSIS-CODE | Retired |
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| Sep 30, 2026 | Molina Healthcare | Hospice Value Code 61PayerPolicy · MOLINA-NY-MEDICARE-HOSPICE-VALUE-CODE-61 | Retired |
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| Sep 30, 2026 | Molina Healthcare | Critical Care Codes when Discharging Home from the Emergency DepartmentPayerPolicy · MOLINA-NY-MEDICARE-CRITICAL-CARE-CODES-WHEN-DISCHARGING-HOME-FROM | Retired |
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| Sep 30, 2026 | Molina Healthcare | Opioid Treatment ServicePayerPolicy · MOLINA-NY-MARKETPLACE-PHARMACY-OPIOID-TREATMENT-SERVICE | Retired |
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| Sep 30, 2026 | Molina Healthcare | Image Guided Radiation TherapyPayerPolicy · MOLINA-NY-MARKETPLACE-RADIOLOGY-IMAGE-GUIDED-RADIATION-THERAPY | Retired |
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| Sep 30, 2026 | Molina Healthcare | Electrocardiographic EKG or ECG Monitoring Holter or Real Time MonitoringPayerPolicy · MOLINA-NY-MARKETPLACE-RADIOLOGY-ELECTROCARDIOGRAPHIC-EKG-OR-ECG-MONITORING-HOLTER | Retired |
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| Sep 30, 2026 | Molina Healthcare | CT Computed Tomography of the Abdomen and PelvisPayerPolicy · MOLINA-NY-MARKETPLACE-RADIOLOGY-CT-COMPUTED-TOMOGRAPHY-OF-THE-ABDOMEN-AND-PELVIS | Retired |
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