| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient SettingPayerPolicy · BCBSKS-CARDIAC-HEMODYNAMIC-MONITORING-FOR-THE-MANAGEMENT-OF-HEART-FAILURE-IN-THE-OUTPATIENT-SETTING | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Breast Reconstructive Surgery After MastectomyPayerPolicy · BCBSKS-BREAST-RECONSTRUCTIVE-SURGERY-AFTER-MASTECTOMY | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Botulinum Toxin (BT)PayerPolicy · BCBSKS-BOTULINUM-TOXIN-BT | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Bone Mineral Density StudiesPayerPolicy · BCBSKS-BONE-MINERAL-DENSITY-STUDIES | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Biomarker Testing in Risk Assessment and Management of Cardiovascular DiseasePayerPolicy · BCBSKS-BIOMARKER-TESTING-IN-RISK-ASSESSMENT-AND-MANAGEMENT-OF-CARDIOVASCULAR-DISEASE | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Bio-Engineered Skin and Soft Tissue SubstitutesPayerPolicy · BCBSKS-BIO-ENGINEERED-SKIN-AND-SOFT-TISSUE-SUBSTITUTES | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | BeqvezPayerPolicy · BCBSKS-BEQVEZ | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Balloon Ostial Dilation for Treatment of Chronic and Recurrent Acute RhinosinusitisPayerPolicy · BCBSKS-BALLOON-OSTIAL-DILATION-FOR-TREATMENT-OF-CHRONIC-AND-RECURRENT-ACUTE-RHINOSINUSITIS | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Balloon Dilation of the Eustachian TubePayerPolicy · BCBSKS-BALLOON-DILATION-OF-THE-EUSTACHIAN-TUBE | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Automated Insulin Delivery SystemsPayerPolicy · BCBSKS-AUTOMATED-INSULIN-DELIVERY-SYSTEMS | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Autologous Chondrocyte Implantation for Focal Articular Cartilage LesionsPayerPolicy · BCBSKS-AUTOLOGOUS-CHONDROCYTE-IMPLANTATION-FOR-FOCAL-ARTICULAR-CARTILAGE-LESIONS | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Autografts and Allografts in the Treatment of Focal Articular Cartilage LesionsPayerPolicy · BCBSKS-AUTOGRAFTS-AND-ALLOGRAFTS-IN-THE-TREATMENT-OF-FOCAL-ARTICULAR-CARTILAGE-LESIONS | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast CancerPayerPolicy · BCBSKS-ASSAYS-OF-GENETIC-EXPRESSION-IN-TUMOR-TISSUE-AS-A-TECHNIQUE-TO-DETERMINE-PROGNOSIS-IN-PATIENTS-WITH-BREAST-CANCER | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Artificial Intervertebral Disc: Lumbar SpinePayerPolicy · BCBSKS-ARTIFICIAL-INTERVERTEBRAL-DISC-LUMBAR-SPINE | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Artificial Intervertebral Disc: Cervical SpinePayerPolicy · BCBSKS-ARTIFICIAL-INTERVERTEBRAL-DISC-CERVICAL-SPINE | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Aqueous Shunts and Stents for GlaucomaPayerPolicy · BCBSKS-AQUEOUS-SHUNTS-AND-STENTS-FOR-GLAUCOMA | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Analysis of Human DNA or RNA in Stool Samples as a Technique for Colorectal Cancer ScreeningPayerPolicy · BCBSKS-ANALYSIS-OF-HUMAN-DNA-OR-RNA-IN-STOOL-SAMPLES-AS-A-TECHNIQUE-FOR-COLORECTAL-CANCER-SCREENING | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Amniotic Membrane and Amniotic FluidPayerPolicy · BCBSKS-AMNIOTIC-MEMBRANE-AND-AMNIOTIC-FLUID | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Ambulatory Event Monitors and Mobile Cardiac Outpatient TelemetryPayerPolicy · BCBSKS-AMBULATORY-EVENT-MONITORS-AND-MOBILE-CARDIAC-OUTPATIENT-TELEMETRY | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Adjustable Cranial Orthoses for Positional Plagiocephaly and CraniosynostosesPayerPolicy · BCBSKS-ADJUSTABLE-CRANIAL-ORTHOSES-FOR-POSITIONAL-PLAGIOCEPHALY-AND-CRANIOSYNOSTOSES | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Accelerated Breast Irradiation and Brachytherapy Boost After Breast-Conserving Surgery for Early Stage Breast CancerPayerPolicy · BCBSKS-ACCELERATED-BREAST-IRRADIATION-AND-BRACHYTHERAPY-BOOST-AFTER-BREAST-CONSERVING-SURGERY-FOR-EARLY-STAGE-BREAST-CANCER | Metadata changed |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | Accelerated Breast Irradiation and Brachytherapy Boost After Breast-Conserving Surgery for Early Stage Breast CancerPayerPolicy · BCBSKS-ACCELERATED-BREAST-IRRADIATION-AND-BRACHYTHERAPY-BOOST-AFTER-BREAST-CONSERVING-SURGERY-FOR-EARLY-STAGE-BREAST-CANCER-FUTURE | New policy |
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| Sep 30, 2026 | Blue Cross and Blue Shield of Kansas | ACA Prevention Copay Waiver Criteria – Individual Marketplace, CommercialPayerPolicy · BCBSKS-ACA-PREVENTION-COPAY-WAIVER-CRITERIA-INDIVIDUAL-MARKETPLACE-COMMERCIAL | Metadata changed |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Maternal Serum Biomarkers for Prediction of Adverse Obstetric OutcomesPayerPolicy · ARKBLUE-MATERNAL-SERUM-BIOMARKERS-FOR-PREDICTION-OF-ADVE-F916890A7F | Retired |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Paliperidone Palmitate (e.g., Long-acting Injectables Invega Sustenna & Invega Trinza, Erzofri)PayerPolicy · ARKBLUE-PALIPERIDONE-PALMITATE-E-G-LONG-ACTING-INJECTABL-319D8B4C9E | Retired |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Mucopolysaccharidoses AgentsPayerPolicy · ARKBLUE-MUCOPOLYSACCHARIDOSES-AGENTS-325112FD7F | Retired |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Biofeedback as a Treatment of Urinary Incontinence in AdultsPayerPolicy · ARKBLUE-BIOFEEDBACK-AS-A-TREATMENT-OF-URINARY-INCONTINEN-48BDE81BFF | Retired |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Biofeedback as a Treatment of HeadachePayerPolicy · ARKBLUE-BIOFEEDBACK-AS-A-TREATMENT-OF-HEADACHE-E886239FB9 | Retired |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Biofeedback as a Treatment of Fecal Incontinence or ConstipationPayerPolicy · ARKBLUE-BIOFEEDBACK-AS-A-TREATMENT-OF-FECAL-INCONTINENCE-007674E6DA | Retired |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Biofeedback as a Treatment of Chronic PainPayerPolicy · ARKBLUE-BIOFEEDBACK-AS-A-TREATMENT-OF-CHRONIC-PAIN-39F519437B | Retired |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Percutaneous Electrical Nerve Field Stimulation for Irritable Bowel SyndromePayerPolicy · ARKBLUE-PERCUTANEOUS-ELECTRICAL-NERVE-FIELD-STIMULATION-1FCFE861B1 | Retired |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Maternal Serum Testing for Prediction of Adverse Obstetric OutcomesPayerPolicy · ARKBLUE-MATERNAL-SERUM-TESTING-FOR-PREDICTION-OF-ADVERSE-OBSTETRIC-OUTCOMES | New policy |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Paliperidone Palmitate (e.g., Long-acting Injectables Invega Sustenna, Invega Trinza, Erzofri, Invega Hafyera)PayerPolicy · ARKBLUE-PALIPERIDONE-PALMITATE-E-G-LONG-ACTING-INJECTABLES-INVEGA-SUSTENNA-INVEGA-TRINZA-ERZOFRI-INVEGA-HAFYERA | New policy |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Mucopolysaccharidoses Agents [Laronidase (e.g., Aldurazyme), Idursulfase (e.g., Elaprase), Elosulfase alfa (e.g., Vimizim), Galsulfase (e.g., Naglazyme), and Vestronidase alfa (e.g., Mepsevii)]PayerPolicy · ARKBLUE-MUCOPOLYSACCHARIDOSES-AGENTS-LARONIDASE-E-G-ALDURAZYME-IDURSULFASE-E-G-ELAPRASE-ELOSULFASE-ALFA-E-G-VIMIZIM-GALSULFASE-E-G-NAGLAZYME-AND-VESTRONIDASE-ALFA-E-G-M | New policy |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Mammography-Based AI (Image-only) Risk Prediction ModelsPayerPolicy · ARKBLUE-MAMMOGRAPHY-BASED-AI-IMAGE-ONLY-RISK-PREDICTION-MODELS | New policy |
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| Sep 30, 2026 | Arkansas Blue Cross and Blue Shield | Percutaneous Electrical Nerve Field Stimulation for Disorders of Gut Brain InteractionPayerPolicy · ARKBLUE-PERCUTANEOUS-ELECTRICAL-NERVE-FIELD-STIMULATION-FOR-DISORDERS-OF-GUT-BRAIN-INTERACTION | New policy |
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| Sep 30, 2026 | AmeriHealth | Ustekinumab for Intravenous UsePayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-042L-FB7F3D389D | Retired |
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| Sep 30, 2026 | AmeriHealth | Treatments for Complex Regional Pain Syndrome (CRPS)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-026N-FA11A0184F | Retired |
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| Sep 30, 2026 | AmeriHealth | Tocilizumab and Related Biosimilars for Intravenous Infusion and Subcutaneous InjectionPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-045Q-15811C2D8A | Retired |
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| Sep 30, 2026 | AmeriHealth | Tildrakizumab-asmn (Ilumya)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-098A-B6C7B88389 | Retired |
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| Sep 30, 2026 | AmeriHealth | Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-004Q-C5B9D73772 | Retired |
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| Sep 30, 2026 | AmeriHealth | Steroid-Eluting Sinus Stents and ImplantsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-107F-2041F675E5 | Retired |
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| Sep 30, 2026 | AmeriHealth | Spinal OrthosesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-030F-11A2FC388D | Retired |
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| Sep 30, 2026 | AmeriHealth | Sleep Disorder Testing and Positive Airway Pressure Therapy Services and SuppliesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA07-058M-ADE6C85689 | Retired |
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| Sep 30, 2026 | AmeriHealth | Remote Electrical Neuromodulation for MigrainesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-071-8A6593674D | Retired |
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| Sep 30, 2026 | AmeriHealth | Psychiatric Collaborative Care Management (CoCM)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-052B-1FF707C1AF | Retired |
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| Sep 30, 2026 | AmeriHealth | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative ServicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-010AV-113AE127D3 | Retired |
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| Sep 30, 2026 | AmeriHealth | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative ServicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-010AV-5B4EDCD063 | Retired |
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| Sep 30, 2026 | AmeriHealth | Pharmacogenetics and Metabolite Monitoring for Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) TherapyPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA06-014E-6049C57577 | Retired |
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| Sep 30, 2026 | AmeriHealth | Peroral Endoscopic Myotomy (POEM) ProceduresPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-117A-AC35BDE7DD | Retired |
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