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 | Priority Health | Surgical Dressings and Wound Care SuppliesPayerPolicy · PRIORITY_HEALTH-91650 | New policy |
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| Sep 30, 2026 | Premera Blue Cross | 15.01.017 (effective September 4, 2026) TestosteronePayerPolicy · PREMERA-15-01-017-EFFECTIVE-SEPTEMBER-4-2026-TESTOSTERONE-5E9E0C317C | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 9.02.501 (effective September 4, 2026) Orthognathic SurgeryPayerPolicy · PREMERA-9-02-501-EFFECTIVE-SEPTEMBER-4-2026-ORTHOGNATHIC-SURGERY-53E2FE19FD | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 11.01.525 (effective September 1, 2026) Site of Service AmbulatoryPayerPolicy · PREMERA-11-01-525-EFFECTIVE-SEPTEMBER-1-2026-SITE-OF-SERVICE-AMBULAT-BBF146D31C | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 7.01.605 (effective September 4, 2026) Shoulder Open ProceduresPayerPolicy · PREMERA-7-01-605-EFFECTIVE-SEPTEMBER-4-2026-SHOULDER-OPEN-PROCEDURES-8DD11BBA2E | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 5.01.658 (effective August 7, 2026) Denosumab ProductsPayerPolicy · PREMERA-5-01-658-EFFECTIVE-AUGUST-7-2026-DENOSUMAB-PRODUCTS-CC51B0F750 | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 1.01.17 (effective September 4, 2026) Pelvic Floor StimulationPayerPolicy · PREMERA-1-01-17-EFFECTIVE-SEPTEMBER-4-2026-PELVIC-FLOOR-STIMULATION-B9ABD69CD8 | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 7.01.605 Shoulder Open Procedures in AdultsPayerPolicy · PREMERA-7-01-605-SHOULDER-OPEN-PROCEDURES-IN-ADULTS-D60707F43C | Retired |
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| Sep 30, 2026 | Premera Blue Cross | Orthoptic Training for the Treatment of Vision or Learning DisabilitiePayerPolicy · PREMERA-ORTHOPTIC-TRAINING-FOR-THE-TREATMENT-OF-VISION-OR-LEARNING-D-5C37324E62 | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 13.01.500 Prescription Digital TherapeuticsPayerPolicy · PREMERA-13-01-500-PRESCRIPTION-DIGITAL-THERAPEUTICS-5F97E78A29 | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 2.02.510 (effective August 7, 2026) Mobile Cardiac OutpatientPayerPolicy · PREMERA-2-02-510-EFFECTIVE-AUGUST-7-2026-MOBILE-CARDIAC-OUTPATIENT-E8C399FC58 | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 2.01.533 (effective September 1, 2026) Upper GastrointestinalPayerPolicy · PREMERA-2-01-533-EFFECTIVE-SEPTEMBER-1-2026-UPPER-GASTROINTESTINAL-C87383028F | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 1.01.508 (effective September 4, 2026) Negative Pressure WoundPayerPolicy · PREMERA-1-01-508-EFFECTIVE-SEPTEMBER-4-2026-NEGATIVE-PRESSURE-WOUND-B6EB8982F5 | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 1.01.508 Negative Pressure Wound Therapy (NPWT) Devices in AdultsPayerPolicy · PREMERA-1-01-508-NEGATIVE-PRESSURE-WOUND-THERAPY-NPWT-DEVICES-IN-ADU-C14C01C0BC | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 2.01.533 Upper Gastrointestinal (UGI) Endoscopy for AdultsPayerPolicy · PREMERA-2-01-533-UPPER-GASTROINTESTINAL-UGI-ENDOSCOPY-FOR-ADULTS-3BC08A5F76 | Retired |
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| Sep 30, 2026 | Premera Blue Cross | 9.03.508 Orthoptic Training for the Treatment of Vision or LearningPayerPolicy · PREMERA-9-03-508-ORTHOPTIC-TRAINING-FOR-THE-TREATMENT-OF-VISION-OR-L-4B1A322937 | New policy |
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| Sep 30, 2026 | Premera Blue Cross | 1.01.17 Pelvic Floor Stimulation as a Treatment of Urinary andPayerPolicy · PREMERA-1-01-17-PELVIC-FLOOR-STIMULATION-AS-A-TREATMENT-OF-URINARY-A-BC30E05E23 | New policy |
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| Sep 30, 2026 | Premera Blue Cross | 7.01.605 Shoulder Open ProceduresPayerPolicy · PREMERA-7-01-605-SHOULDER-OPEN-PROCEDURES-D4B2B6E19D | New policy |
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| Sep 30, 2026 | Premera Blue Cross | 5.01.574 (effective December 3, 2026) Pharmacotherapy of SpinalPayerPolicy · PREMERA-5-01-574-EFFECTIVE-DECEMBER-3-2026-PHARMACOTHERAPY-OF-SPINAL-1C67D3426B | New policy |
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| Sep 30, 2026 | Premera Blue Cross | 3.03.500 Prescription Digital TherapeuticsPayerPolicy · PREMERA-3-03-500-PRESCRIPTION-DIGITAL-THERAPEUTICS-A384A40B40 | New policy |
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| Sep 30, 2026 | Premera Blue Cross | 7.01.549 (effective December 3, 2026) Knee Arthroscopy in AdultsPayerPolicy · PREMERA-7-01-549-EFFECTIVE-DECEMBER-3-2026-KNEE-ARTHROSCOPY-IN-ADULT-CEA8F3D0DA | New policy |
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| Sep 30, 2026 | Premera Blue Cross | 1.01.508 Negative Pressure Wound Therapy (NPWT) DevicesPayerPolicy · PREMERA-1-01-508-NEGATIVE-PRESSURE-WOUND-THERAPY-NPWT-DEVICES-5F30D1C441 | New policy |
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| Sep 30, 2026 | Premera Blue Cross | 2.01.533 Upper Gastrointestinal (UGI) Endoscopy in AdultsPayerPolicy · PREMERA-2-01-533-UPPER-GASTROINTESTINAL-UGI-ENDOSCOPY-IN-ADULTS-1E62998BF3 | New policy |
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| Sep 30, 2026 | Point32Health | Xolair (omalizumab) Prefilled Syringe for Self-administrationPayerPolicy · POINT32HEALTH-PMNG-17701 | Retired |
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| Sep 30, 2026 | Point32Health | Xolair (omalizumab) Pre-filled Syringe for Self-administrationPayerPolicy · POINT32HEALTH-PMNG-17691 | Retired |
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| Sep 30, 2026 | Point32Health | Tezspire (tezepelumab-ekko) Pre-filled PenPayerPolicy · POINT32HEALTH-PMNG-17441 | Retired |
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| Sep 30, 2026 | Point32Health | Nucala (mepolizumab) Pre-filled Autoinjector and SyringePayerPolicy · POINT32HEALTH-PMNG-17056 | Retired |
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| Sep 30, 2026 | Point32Health | New-To-Market DrugsPayerPolicy · POINT32HEALTH-PMNG-16596 | Retired |
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| Sep 30, 2026 | Point32Health | HMG-CoA Reductase InhibitorsPayerPolicy · POINT32HEALTH-PMNG-15816 | Retired |
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| Sep 30, 2026 | Point32Health | Fasenra (benralizumab) Pen (autoinjector)PayerPolicy · POINT32HEALTH-PMNG-15521 | Retired |
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| Sep 30, 2026 | Point32Health | Ezetimibe/simvastatinPayerPolicy · POINT32HEALTH-PMNG-15501 | Retired |
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| Sep 30, 2026 | Point32Health | Dupixent (dupilumab)PayerPolicy · POINT32HEALTH-PMNG-27771 | Retired |
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| Sep 30, 2026 | Point32Health | Bepreve (bepotastine)PayerPolicy · POINT32HEALTH-PMNG-14881 | Retired |
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| Sep 30, 2026 | Point32Health | Home Health Care Services for Tufts Health RITogether and Tufts Health One CarePayerPolicy · POINT32HEALTH-MNG-28441 | Retired |
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| Sep 30, 2026 | Point32Health | Xolair (omalizumab)PayerPolicy · POINT32HEALTH-MDMNG-14391 | Retired |
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| Sep 30, 2026 | Point32Health | Tezspire (tezepelumab-ekko)PayerPolicy · POINT32HEALTH-MDMNG-14096 | Retired |
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| Sep 30, 2026 | Point32Health | Respiratory InterleukinsPayerPolicy · POINT32HEALTH-MDMNG-13596 | Retired |
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| Sep 30, 2026 | Point32Health | Xiaflex (collagenase clostridium histolyticum)PayerPolicy · POINT32HEALTH-PMNG-18091 | Metadata changed |
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| Sep 30, 2026 | Point32Health | Xerese (acyclovir and hydrocortisone)PayerPolicy · POINT32HEALTH-PMNG-29181 | New policy |
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| Sep 30, 2026 | Point32Health | Vykat XRPayerPolicy · POINT32HEALTH-PMNG-28711 | New policy |
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| Sep 30, 2026 | Point32Health | Vanrafia (atrasentan)PayerPolicy · POINT32HEALTH-PMNG-28701 | New policy |
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| Sep 30, 2026 | Point32Health | Tarpeyo (budesonide)PayerPolicy · POINT32HEALTH-PMNG-16986 | Metadata changed |
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| Sep 30, 2026 | Point32Health | Sofosbuvir/velpatasvirPayerPolicy · POINT32HEALTH-PMNG-29171 | New policy |
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| Sep 30, 2026 | Point32Health | Sodium-Glucose Co-Transporter 2 (SGLT2) InhibitorsPayerPolicy · POINT32HEALTH-PMNG-29161 | New policy |
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| Sep 30, 2026 | Point32Health | Sodium-Glucose Co-Transporter 2 (SGLT2) InhibitorsPayerPolicy · POINT32HEALTH-PMNG-28981 | New policy |
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| Sep 30, 2026 | Point32Health | Pegfilgrastim ProductsPayerPolicy · POINT32HEALTH-PMNG-29001 | New policy |
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| Sep 30, 2026 | Point32Health | Oral Antifungal AgentsPayerPolicy · POINT32HEALTH-PMNG-17231 | Metadata changed |
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| Sep 30, 2026 | Point32Health | Mavyret (glecaprevir/pibrentasvir)PayerPolicy · POINT32HEALTH-PMNG-29151 | New policy |
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| Sep 30, 2026 | Point32Health | Livmarli (maralixibat)PayerPolicy · POINT32HEALTH-PMNG-16176 | Metadata changed |
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| Sep 30, 2026 | Point32Health | Ledipasvir/sofosbuvirPayerPolicy · POINT32HEALTH-PMNG-29141 | New policy |
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