Coverage policy updates

Policy changes Backwork has recorded, newest first. The most recent change on record is from October 14, 2026. Changes appear here after Backwork reviews and applies a refresh, so this page can trail the payers’ own sites.

Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.

Recorded changes

83,427 on record

Recorded policy changes, newest first
Recorded	Payer	Policy	Change
Aug 2, 2026	Clover Health	Specialty Exceptions Osteoporosis-Hypercalcemia of Malignancy Med B ABF 3792-D P01-2026PayerPolicy · CLOVER-PARTB-7126	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Osteoporosis-Bone Density Med B 5826-D P01-2026PayerPolicy · CLOVER-PARTB-7100	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Multiple Sclerosis Med B ABF 6398-D P01-2026PayerPolicy · CLOVER-PARTB-7120	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Immune Globulins MED B-MED B ABF 3797-D P2026PayerPolicy · CLOVER-PARTB-7108	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions IV Iron MED B-MED B ABF 5895-D P2026PayerPolicy · CLOVER-PARTB-7122	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Hyaluronates MED B-MED B ABF 4664-D P2026PayerPolicy · CLOVER-PARTB-7116	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions GnRH-Prostate MED B-MED B ABF 4257-D P2026PayerPolicy · CLOVER-PARTB-7125	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Gaucher_s disease MED B-MED B ABF 4219-D P2026PayerPolicy · CLOVER-PARTB-7124	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Factor VIII products MED B-MED B ABF 5894-D P2026PayerPolicy · CLOVER-PARTB-7113	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions ESAs Med B ABF 5278-D P2026PayerPolicy · CLOVER-PARTB-7111	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Complement Inhibitors MED B ABF 3801-D P2026PayerPolicy · CLOVER-PARTB-7117	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions CSF-Short Acting Med B-Med B ABF 4282-D P2026PayerPolicy · CLOVER-PARTB-7121	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions CSF-Long Acting Med B ABF 5280-D P2026PayerPolicy · CLOVER-PARTB-7112	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Botulinum Toxins MED B-MED B ABF 4248-D P2026PayerPolicy · CLOVER-PARTB-7110	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Autoimmune-Infliximab Med B-Med B ABF 5290-D P2026PayerPolicy · CLOVER-PARTB-7109	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Autoimmune Med B ABF 6931-D P2026PayerPolicy · CLOVER-PARTB-7115	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Asthma Med B-Med B ABF 4659-D P2026PayerPolicy · CLOVER-PARTB-7114	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Antimetabolites MED B-MED B ABF 5892-D P2026PayerPolicy · CLOVER-PARTB-7107	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Alpha1-Proteinase Inh MED B-MED B ABF 3445-D P2026PayerPolicy · CLOVER-PARTB-7104	New policy
Aug 2, 2026	Clover Health	Specialty Exceptions Acromegaly - Long Acting MED B-MED B ABF 4255-D P2026PayerPolicy · CLOVER-PARTB-7105	New policy
Aug 2, 2026	Clover Health	January 2026 Medical Preferred Drug List_MEDICARE 04.10.25PayerPolicy · CLOVER-PARTB-7102	New policy
Aug 2, 2026	Clover Health	Clover Health 2026 Advanced Biosimilars First Medical Preferred Drug ListPayerPolicy · CLOVER-PARTB-7106	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Wireless Capsule Endoscopy for Gastrointestinal (GI) DisordersPayerPolicy · BCBSVT-WIRELESS-CAPSULE-ENDOSCOPY-FOR-GASTROINTESTINAL	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Whole Body MRIPayerPolicy · BCBSVT-WHOLE-BODY-MRI	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	WheelchairsPayerPolicy · BCBSVT-WHEELCHAIRS	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Wearable Cardioverter DefibrillatorsPayerPolicy · BCBSVT-WEARABLE-CARDIOVERTER-DEFIBRILLATORS	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Vision Services and Medical Coverage for Ocular DiseasePayerPolicy · BCBSVT-VISION-SERVICES-AND-MEDICAL-COVERAGE-FOR-OCULAR	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Use of Intravascular Ultrasound and Optical Coherence TomographyPayerPolicy · BCBSVT-USE-OF-INTRAVASCULAR-ULTRASOUND-AND-OPTICAL-COHE-B9D9842222	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Use of Intravascular Ultrasound and Optical Coherence TomographyPayerPolicy · BCBSVT-USE-OF-INTRAVASCULAR-ULTRASOUND-AND-OPTICAL-COHE	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Tumor Treatment Fields Therapy for CNS CancersPayerPolicy · BCBSVT-TUMOR-TREATMENT-FIELDS-THERAPY-FOR-CNS-CANCERS	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Treatment of Varicose Veins/Venous InsufficiencyPayerPolicy · BCBSVT-TREATMENT-OF-VARICOSE-VEINS-VENOUS-INSUFFICIENCY	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Transcutaneous Electrical Nerve Stimulation (TENS)PayerPolicy · BCBSVT-TRANSCUTANEOUS-ELECTRICAL-NERVE-STIMULATION-TENS	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic DisordersPayerPolicy · BCBSVT-TRANSCRANIAL-MAGNETIC-STIMULATION-AS-A-TREATMENT-2A12D3E0FE	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic DisordersPayerPolicy · BCBSVT-TRANSCRANIAL-MAGNETIC-STIMULATION-AS-A-TREATMENT	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Total Parenteral Nutrition (TPN) in the Home SettingPayerPolicy · BCBSVT-TOTAL-PARENTERAL-NUTRITION-TPN-IN-THE-HOME-SETTI	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Temporomandibular Joints (TMJ) DysfunctionPayerPolicy · BCBSVT-TEMPOROMANDIBULAR-JOINTS-TMJ-DYSFUNCTION	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Telemedicine and TelehealthPayerPolicy · BCBSVT-TELEMEDICINE-AND-TELEHEALTH	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Speech Language Pathology/Therapy ServicePayerPolicy · BCBSVT-SPEECH-LANGUAGE-PATHOLOGY-THERAPY-SERVICE-FUTURE	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Speech Language Pathology/Therapy ServicePayerPolicy · BCBSVT-SPEECH-LANGUAGE-PATHOLOGY-THERAPY-SERVICE	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Sleep Disorders Diagnosis & TreatmentPayerPolicy · BCBSVT-SLEEP-DISORDERS-DIAGNOSIS-TREATMENT	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Single Photon Emission Computer Tomography (SPECT/CT) Imaging for the Evaluation of the SpinePayerPolicy · BCBSVT-SINGLE-PHOTON-EMISSION-COMPUTER-TOMOGRAPHY-SPECT-4366B62218	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Single Photon Emission Computer Tomography (SPECT/CT) Imaging for the Evaluation of the SpinePayerPolicy · BCBSVT-SINGLE-PHOTON-EMISSION-COMPUTER-TOMOGRAPHY-SPECT	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Radiology - Cardiac Related ImagingPayerPolicy · BCBSVT-RADIOLOGY-CARDIAC-RELATED-IMAGING	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Radiology - All other Non-Cardiac ImagingPayerPolicy · BCBSVT-RADIOLOGY-ALL-OTHER-NON-CARDIAC-IMAGING	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Psychological and Neuropsychological TestingPayerPolicy · BCBSVT-PSYCHOLOGICAL-AND-NEUROPSYCHOLOGICAL-TESTING-9993203C87	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Psychological and Neuropsychological TestingPayerPolicy · BCBSVT-PSYCHOLOGICAL-AND-NEUROPSYCHOLOGICAL-TESTING	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Private Inpatient Hospital RoomsPayerPolicy · BCBSVT-PRIVATE-INPATIENT-HOSPITAL-ROOMS	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Physical Therapy MedicinePayerPolicy · BCBSVT-PHYSICAL-THERAPY-MEDICINE-FUTURE	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Physical Therapy MedicinePayerPolicy · BCBSVT-PHYSICAL-THERAPY-MEDICINE	New policy
Aug 2, 2026	Blue Cross and Blue Shield of Vermont	Percutaneous Electrical Nerve Field Stimulation for Irritable Bowel SyndromePayerPolicy · BCBSVT-PERCUTANEOUS-ELECTRICAL-NERVE-FIELD-STIMULATION	New policy