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 | Oscar Health | Antineoplastics - Cyclophosphamide Products - Medical Benefit Preferred Physician-Administered Drug Exceptions Criteria (CG120, Ver. 2)PayerPolicy · OSCAR-CG120-MEDICAL | New policy |
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| Sep 30, 2026 | Oscar Health | Antineoplastic and Immunomodulating Agents - Tocilizumab Products - Medical Benefit Preferred Physician-Administered Drug Exceptions Criteria (CG108, Ver. 4)PayerPolicy · OSCAR-CG108-MEDICAL | New policy |
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| Sep 30, 2026 | Oscar Health | Antiemetics - Substance P/Neurokinin 1 (NK1) Antagonist (i.e., Fosaprepitant Products) - Medical Benefit Preferred Physician-Administered Drug Exceptions Criteria (CG103, Ver. 2)PayerPolicy · OSCAR-CG103-MEDICAL | New policy |
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| Sep 30, 2026 | Oscar Health | Agents for Amyloidosis-Associated Polyneuropathy - Medical Benefit Preferred Physician-Administered Drug Exceptions Criteria (CG109, Ver. 2)PayerPolicy · OSCAR-CG109-MEDICAL | New policy |
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| Sep 30, 2026 | Oscar Health | Adakveo (crizanlizumab) (PG193, Ver. 3)PayerPolicy · OSCAR-PG193-MEDICAL | Metadata changed |
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| Sep 30, 2026 | Oscar Health | Acupuncture (CG013, Ver. 12)PayerPolicy · OSCAR-CG013-MEDICAL | Metadata changed |
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| Sep 30, 2026 | Oscar Health | American Society of Addiction Medicine (ASAM)PayerPolicy · OSCAR-AMERICAN-SOCIETY-OF-ADDICTION-MEDICINE-ASAM-ADOPTED | Metadata changed |
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| Sep 30, 2026 | Humana | Rheumatoid Arthritis: Biologic Markers and Pharmacologic AssessmentPayerPolicy · HUMANA-RHEUMATOID-ARTHRITIS-BIOLOGIC-MARKERS-AND-PHARMACOLOGIC-ASSESSMENT-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Rethymic (allogenic processed thymus tissue - agdc)PayerPolicy · HUMANA-RETHYMIC-ALLOGENIC-PROCESSED-THYMUS-TISSUE-AGDC-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Peripheral Artery Revascularization of the Lower ExtremitiesPayerPolicy · HUMANA-PERIPHERAL-ARTERY-REVASCULARIZATION-OF-THE-LOWER-EXTREMITIES-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Outpatient Rehabilitation (Skilled Therapy)PayerPolicy · HUMANA-OUTPATIENT-REHABILITATION-SKILLED-THERAPY-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Noninvasive Tests for Hepatic FibrosisPayerPolicy · HUMANA-NONINVASIVE-TESTS-FOR-HEPATIC-FIBROSIS-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Nerve Stimulation for Urinary IncontinencePayerPolicy · HUMANA-NERVE-STIMULATION-FOR-URINARY-INCONTINENCE-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Multianalyte Assays with Algorithmic Analyses for Cancer IndicationsPayerPolicy · HUMANA-MULTIANALYTE-ASSAYS-WITH-ALGORITHMIC-ANALYSES-FOR-CANCER-INDICATIONS-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Molecular Diagnostic Assays and Breath Testing for Transplant RejectionPayerPolicy · HUMANA-MOLECULAR-DIAGNOSTIC-ASSAYS-AND-BREATH-TESTING-FOR-TRANSPLANT-REJECTION-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Molecular Biomarkers for Prostate Cancer Risk StratificationPayerPolicy · HUMANA-MOLECULAR-BIOMARKERS-FOR-PROSTATE-CANCER-RISK-STRATIFICATION-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Interspinous Process Decompression SpacersPayerPolicy · HUMANA-INTERSPINOUS-PROCESS-DECOMPRESSION-SPACERS-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Brain Stimulation TreatmentsPayerPolicy · HUMANA-BRAIN-STIMULATION-TREATMENTS-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Hematopoietic Stem Cell TransplantationPayerPolicy · HUMANA-HEMATOPOIETIC-STEM-CELL-TRANSPLANTATION-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Elective Aorta and Iliac Artery Aneurysm RepairPayerPolicy · HUMANA-ELECTIVE-AORTA-AND-ILIAC-ARTERY-ANEURYSM-REPAIR-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Bariatric SurgeryPayerPolicy · HUMANA-BARIATRIC-SURGERY-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Diagnostic and Therapeutic Esophagogastroduodenoscopy or EsophagoscopyPayerPolicy · HUMANA-DIAGNOSTIC-AND-THERAPEUTIC-ESOPHAGOGASTRODUODENOSCOPY-OR-ESOPHAGOSCOPY-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Cosmetic and Reconstructive SurgeryPayerPolicy · HUMANA-COSMETIC-AND-RECONSTRUCTIVE-SURGERY-MA | Metadata changed |
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| Sep 30, 2026 | Humana | BrachytherapyPayerPolicy · HUMANA-BRACHYTHERAPY-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Hyperthermia and Ultrasound-Based Ablative Cancer TreatmentsPayerPolicy · HUMANA-HYPERTHERMIA-AND-ULTRASOUND-BASED-ABLATIVE-CANCER-TREATMENTS-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Gene Expression Profiling for Cancer IndicationsPayerPolicy · HUMANA-GENE-EXPRESSION-PROFILING-FOR-CANCER-INDICATIONS-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Irreversible ElectroporationPayerPolicy · HUMANA-IRREVERSIBLE-ELECTROPORATION-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Genetic Testing for Hereditary Breast, Ovarian, Pancreatic and Prostate CancerPayerPolicy · HUMANA-GENETIC-TESTING-FOR-HEREDITARY-BREAST-OVARIAN-PANCREATIC-AND-PROSTATE-CANCER-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Carpal Tunnel Syndrome Surgical TreatmentsPayerPolicy · HUMANA-CARPAL-TUNNEL-SYNDROME-SURGICAL-TREATMENTS-MA | Metadata changed |
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| Sep 30, 2026 | Humana | Rheumatoid Arthritis: Biologic Markers and Pharmacologic AssessmentPayerPolicy · HUMANA-RHEUMATOID-ARTHRITIS-BIOLOGIC-MARKERS-AND-PHARMACOLOGIC-ASSESSMENT-MA-EFF-20251001 | Retired |
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| Sep 30, 2026 | Humana | Rethymic (allogenic processed thymus tissue - agdc)PayerPolicy · HUMANA-RETHYMIC-ALLOGENIC-PROCESSED-THYMUS-TISSUE-AGDC-MA-EFF-20251001 | Retired |
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| Sep 30, 2026 | Humana | Peripheral Artery Revascularization of the Lower ExtremitiesPayerPolicy · HUMANA-PERIPHERAL-ARTERY-REVASCULARIZATION-OF-THE-LOWER-EXTREMITIES-MA-EFF-20260501 | Retired |
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| Sep 30, 2026 | Humana | Outpatient Rehabilitation (Skilled Therapy)PayerPolicy · HUMANA-OUTPATIENT-REHABILITATION-SKILLED-THERAPY-MA-EFF-20260701 | Retired |
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| Sep 30, 2026 | Humana | Noninvasive Tests for Hepatic FibrosisPayerPolicy · HUMANA-NONINVASIVE-TESTS-FOR-HEPATIC-FIBROSIS-MA-EFF-20260810 | Retired |
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| Sep 30, 2026 | Humana | Nerve Stimulation for Urinary IncontinencePayerPolicy · HUMANA-NERVE-STIMULATION-FOR-URINARY-INCONTINENCE-MA-EFF-20260401 | Retired |
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| Sep 30, 2026 | Humana | Multianalyte Assays with Algorithmic Analyses for Cancer IndicationsPayerPolicy · HUMANA-MULTIANALYTE-ASSAYS-WITH-ALGORITHMIC-ANALYSES-FOR-CANCER-INDICATIONS-MA-EFF-20260501 | Retired |
|---|
| Sep 30, 2026 | Humana | Molecular Diagnostic Assays and Breath Testing for Transplant RejectionPayerPolicy · HUMANA-MOLECULAR-DIAGNOSTIC-ASSAYS-AND-BREATH-TESTING-FOR-TRANSPLANT-REJECTION-MA-EFF-20260830 | Retired |
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| Sep 30, 2026 | Humana | Molecular Biomarkers for Prostate Cancer Risk StratificationPayerPolicy · HUMANA-MOLECULAR-BIOMARKERS-FOR-PROSTATE-CANCER-RISK-STRATIFICATION-MA-EFF-20251001 | Retired |
|---|
| Sep 30, 2026 | Humana | Irreversible ElectroporationPayerPolicy · HUMANA-IRREVERSIBLE-ELECTROPORATION-MA-EFF-20260705 | Retired |
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| Sep 30, 2026 | Humana | Interspinous Process Decompression SpacersPayerPolicy · HUMANA-INTERSPINOUS-PROCESS-DECOMPRESSION-SPACERS-MA-EFF-20251103 | Retired |
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| Sep 30, 2026 | Humana | Hyperthermia and Ultrasound-Based Ablative Cancer TreatmentsPayerPolicy · HUMANA-HYPERTHERMIA-AND-ULTRASOUND-BASED-ABLATIVE-CANCER-TREATMENTS-MA-EFF-20260401 | Retired |
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| Sep 30, 2026 | Humana | Hematopoietic Stem Cell TransplantationPayerPolicy · HUMANA-HEMATOPOIETIC-STEM-CELL-TRANSPLANTATION-MA-EFF-20251201 | Retired |
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| Sep 30, 2026 | Humana | Genetic Testing for Hereditary Breast, Ovarian, Pancreatic and Prostate CancerPayerPolicy · HUMANA-GENETIC-TESTING-FOR-HEREDITARY-BREAST-OVARIAN-PANCREATIC-AND-PROSTATE-CANCER-MA-EFF-20260803 | Retired |
|---|
| Sep 30, 2026 | Humana | Gene Expression Profiling for Cancer IndicationsPayerPolicy · HUMANA-GENE-EXPRESSION-PROFILING-FOR-CANCER-INDICATIONS-MA-EFF-20260501 | Retired |
|---|
| Sep 30, 2026 | Humana | Elective Aorta and Iliac Artery Aneurysm RepairPayerPolicy · HUMANA-ELECTIVE-AORTA-AND-ILIAC-ARTERY-ANEURYSM-REPAIR-MA-EFF-20260202 | Retired |
|---|
| Sep 30, 2026 | Humana | Diagnostic and Therapeutic Esophagogastroduodenoscopy or EsophagoscopyPayerPolicy · HUMANA-DIAGNOSTIC-AND-THERAPEUTIC-ESOPHAGOGASTRODUODENOSCOPY-OR-ESOPHAGOSCOPY-MA-EFF-20260302 | Retired |
|---|
| Sep 30, 2026 | Humana | Cosmetic and Reconstructive SurgeryPayerPolicy · HUMANA-COSMETIC-AND-RECONSTRUCTIVE-SURGERY-MA-EFF-20260302 | Retired |
|---|
| Sep 30, 2026 | Humana | Carpal Tunnel Syndrome Surgical TreatmentsPayerPolicy · HUMANA-CARPAL-TUNNEL-SYNDROME-SURGICAL-TREATMENTS-MA-EFF-20260803 | Retired |
|---|
| Sep 30, 2026 | Humana | Brain Stimulation TreatmentsPayerPolicy · HUMANA-BRAIN-STIMULATION-TREATMENTS-MA-EFF-20251103 | Retired |
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| Sep 30, 2026 | Humana | BrachytherapyPayerPolicy · HUMANA-BRACHYTHERAPY-MA-EFF-20260302 | Retired |
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