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 |
|---|
| Sep 30, 2026 | Molina Healthcare | Medically Unlikely EditsPayerPolicy · MOLINA-NM-MARKETPLACE-MEDICALLY-UNLIKELY-EDITS | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | ICD-10 SpecificityPayerPolicy · MOLINA-NM-MARKETPLACE-ICD-10-SPECIFICITY | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | ICD-10 First Listed Diagnosis Coding PolicyPayerPolicy · MOLINA-NM-MARKETPLACE-CODING-ICD-10-FIRST-LISTED-DIAGNOSIS-CODING-POLICY | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Facility Bilateral or Anatomical Modifier UsePayerPolicy · MOLINA-NM-MARKETPLACE-FACILITY-BILATERAL-OR-ANATOMICAL-MODIFIER-USE | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Emergency EM Codes and Place of ServicePayerPolicy · MOLINA-NM-MARKETPLACE-EMERGENCY-EM-CODES-AND-PLACE-OF-SERVICE | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Diagnosis Code CodingPayerPolicy · MOLINA-NM-MARKETPLACE-CODING-DIAGNOSIS-CODE-CODING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Critical Care Codes when Discharging Home from the Emergency DepartmentPayerPolicy · MOLINA-NM-MARKETPLACE-CRITICAL-CARE-CODES-WHEN-DISCHARGING-HOME-FROM | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Co Surgeon Team Surgeon ProfessionalPayerPolicy · MOLINA-NM-MARKETPLACE-CO-SURGEON-TEAM-SURGEON-PROFESSIONAL | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Anesthesia BundlingPayerPolicy · MOLINA-NM-MARKETPLACE-ANESTHESIA-BUNDLING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Appropriate Level of Care ReimbursementPayerPolicy · MOLINA-NV-MEDICAID-CLINICAL-APPROPRIATE-LEVEL-OF-CARE-REIMBURSEMENT | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | High Dollar PharmacyPayerPolicy · MOLINA-NV-MEDICARE-PHARMACY-HIGH-DOLLAR-PHARMACY | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Pulmonary Function TestingPayerPolicy · MOLINA-NV-MEDICARE-RADIOLOGY-PULMONARY-FUNCTION-TESTING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Electrocardiographic EKG or ECG Monitoring Holteror Real Time MonitoringPayerPolicy · MOLINA-NV-MEDICARE-RADIOLOGY-ELECTROCARDIOGRAPHIC-EKG-OR-ECG-MONITORING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | CT Computed Tomography of the Abdomen and PelvisPayerPolicy · MOLINA-NV-MEDICARE-RADIOLOGY-CT-COMPUTED-TOMOGRAPHY-OF-THE-ABDOMEN-AND-PELVIS | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Aortography and Peripheral AngiographyPayerPolicy · MOLINA-NV-MEDICARE-RADIOLOGY-AORTOGRAPHY-AND-PERIPHERAL-ANGIOGRAPHY | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | ESRD Billing for J0406 or J0606 with Modifier AXPayerPolicy · MOLINA-NV-MEDICARE-ESRD-ESRD-BILLING-FOR-J0406-OR-J0606-WITH-MODIFIER-AX | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | DME Non Invasive Ventilator SettingsPayerPolicy · MOLINA-NV-MEDICARE-DME-DME-NON-INVASIVE-VENTILATOR-SETTINGS | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | DME KF ModifierPayerPolicy · MOLINA-NV-MEDICARE-DME-DME-KF-MODIFIER | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Recovery Policy Variable Discount Payments for ProvidersPayerPolicy · MOLINA-NV-MEDICARE-ADMINISTRATIVE-RECOVERY-POLICY-VARIABLE-DISCOUNT-PAYMENTS-FOR | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Recovery Policy for Diagnosis CodesPayerPolicy · MOLINA-NV-MEDICARE-ADMINISTRATIVE-RECOVERY-POLICY-FOR-DIAGNOSIS-CODES | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Recovery Policy for CPT to CPT CodePayerPolicy · MOLINA-NV-MEDICARE-ADMINISTRATIVE-RECOVERY-POLICY-FOR-CPT-TO-CPT-CODE | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Multiple Procedure Payment ReductionPayerPolicy · MOLINA-NV-MEDICARE-ADMINISTRATIVE-MULTIPLE-PROCEDURE-PAYMENT-REDUCTION | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | General Billing and Coding PolicyPayerPolicy · MOLINA-NV-MEDICARE-ADMINISTRATIVE-GENERAL-BILLING-AND-CODING-POLICY | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Cross-Departmental Recovery PolicyPayerPolicy · MOLINA-NV-MEDICARE-ADMINISTRATIVE-CROSS-DEPARTMENTAL-RECOVERY-POLICY | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Authorization ReviewPayerPolicy · MOLINA-NV-MEDICARE-ADMINISTRATIVE-AUTHORIZATION-REVIEW | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | After Hours and Weekend Care ProfessionalPayerPolicy · MOLINA-NV-MEDICARE-ADMINISTRATIVE-AFTER-HOURS-AND-WEEKEND-CARE-PROFESSIONAL | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | G2031 Allergen TestingPayerPolicy · MOLINA-NV-MEDICARE-LAB-G2031-ALLERGEN-TESTING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | G2036 Hepatitis TestingPayerPolicy · MOLINA-NV-MEDICARE-LAB-G2036-HEPATITIS-TESTING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | G2044 Helicobacter pylori TestingPayerPolicy · MOLINA-NV-MEDICARE-LAB-G2044-HELICOBACTER-PYLORI-TESTING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | G2050 Cardiovascular Disease Risk AssessmentPayerPolicy · MOLINA-NV-MEDICARE-LAB-G2050-CARDIOVASCULAR-DISEASE-RISK-ASSESSMENT | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | G2099 Intracellular Micronutrient AnalysisPayerPolicy · MOLINA-NV-MEDICARE-LAB-G2099-INTRACELLULAR-MICRONUTRIENT-ANALYSIS | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | G2124 Serum Tumor Markers for MalignanciesPayerPolicy · MOLINA-NV-MEDICARE-LAB-G2124-SERUM-TUMOR-MARKERS-FOR-MALIGNANCIES | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | G2149 Pathogen Panel TestingPayerPolicy · MOLINA-NV-MEDICARE-LAB-G2149-PATHOGEN-PANEL-TESTING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | G2151 Serum Testing For Evidence of Mild Traumatic Brain InjuryPayerPolicy · MOLINA-NV-MEDICARE-LAB-G2151-SERUM-TESTING-FOR-EVIDENCE-OF-MILD | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | G2164 Parathyroid Hormone Phosphorus Calcium and Magnesium TestingPayerPolicy · MOLINA-NV-MEDICARE-LAB-G2164-PARATHYROID-HORMONE-PHOSPHORUS-CALCIUM-AND | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | R2162 Laboratory Procedures ReimbursementPayerPolicy · MOLINA-NV-MEDICARE-LAB-R2162-LABORATORY-PROCEDURES-REIMBURSEMENT | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | G2006 Diabetes Mellitus TestingPayerPolicy · MOLINA-NV-MEDICARE-LAB-G2006-DIABETES-MELLITUS-TESTING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Optum EDC Analyzer - Facility ER E&M Leveling PrepaymentPayerPolicy · MOLINA-NV-MEDICARE-CLINICAL-OPTUM-EDC-ANALYZER-FACILITY-ER-E-M-LEVELING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Optum Pause and PayPayerPolicy · MOLINA-NV-MEDICARE-CLINICAL-OPTUM-PAUSE-AND-PAY | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | High Level Evaluation and Management with Preventive MedicinePayerPolicy · MOLINA-NV-MEDICARE-CLINICAL-HIGH-LEVEL-EVALUATION-AND-MANAGEMENT-WITH | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Unspecified Codes in an Inpatient SettingPayerPolicy · MOLINA-NV-MEDICARE-UNSPECIFIED-CODES-IN-AN-INPATIENT-SETTING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Status Indicator Flag B Bundled CodesPayerPolicy · MOLINA-NV-MEDICARE-STATUS-INDICATOR-FLAG-B-BUNDLED-CODES | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | NPFS Status Indicator TPayerPolicy · MOLINA-NV-MEDICARE-NPFS-STATUS-INDICATOR-T | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Member PCP as Attending Provider in a ER Facility SettingPayerPolicy · MOLINA-NV-MEDICARE-MEMBER-PCP-AS-ATTENDING-PROVIDER-IN-A-ER-FACILITY | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Inpatient services billed on Outpatient bill typesPayerPolicy · MOLINA-NV-MEDICARE-INPATIENT-SERVICES-BILLED-ON-OUTPATIENT-BILL-TYPES | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Facility Bilateralor Anatomical Modifier UsePayerPolicy · MOLINA-NV-MEDICARE-FACILITY-BILATERALOR-ANATOMICAL-MODIFIER-USE | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Emergency EM Codesand Place of ServicePayerPolicy · MOLINA-NV-MEDICARE-EMERGENCY-EM-CODESAND-PLACE-OF-SERVICE | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Diagnosis Code CodingPayerPolicy · MOLINA-NV-MEDICARE-CODING-DIAGNOSIS-CODE-CODING | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | CMS Replacement CodesPayerPolicy · MOLINA-NV-MEDICARE-CMS-REPLACEMENT-CODES | Retired |
|---|
| Sep 30, 2026 | Molina Healthcare | Self Administered DrugsPayerPolicy · MOLINA-NV-MARKETPLACE-PHARMACY-SELF-ADMINISTERED-DRUGS | Retired |
|---|