Coverage policy updates

Policy changes Backwork has recorded, newest first. The most recent change on record is from October 24, 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

86,510 on record

Recorded policy changes, newest first
Recorded	Payer	Policy	Change
Aug 2, 2026	AmeriHealth	Rhytidectomy and/or Cervicoplasty With or Without Liposuction and/or PlatysmaplastyPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-075	New policy
Aug 2, 2026	AmeriHealth	Revakinagene taroretcel-lwey (Encelto)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-013	New policy
Aug 2, 2026	AmeriHealth	Retifanlimab-dlwr (Zynyz)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-161	New policy
Aug 2, 2026	AmeriHealth	Reporting Requirements for Drugs and BiologicsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-024	New policy
Aug 2, 2026	AmeriHealth	Reporting and Documentation Requirements for Anesthesia ServicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-009	New policy
Aug 2, 2026	AmeriHealth	Repair or Replacement of an External Prosthetic DevicePayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-063	New policy
Aug 2, 2026	AmeriHealth	Repair and Replacement of Durable Medical Equipment (DME) and Prosthetic DevicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-062	New policy
Aug 2, 2026	AmeriHealth	Renal Denervation for Uncontrolled HypertensionPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-120	New policy
Aug 2, 2026	AmeriHealth	Removal of Breast ImplantsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-076	New policy
Aug 2, 2026	AmeriHealth	Remote Patient MonitoringPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA12-010	New policy
Aug 2, 2026	AmeriHealth	Remote Electrical Neuromodulation for MigrainesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-071-8A6593674D	New policy
Aug 2, 2026	AmeriHealth	Reimbursement of Surgical Pathology Services for Prostate BiopsyPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-058	New policy
Aug 2, 2026	AmeriHealth	Reimbursement for the Administration of ImmunizationsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA07-019	New policy
Aug 2, 2026	AmeriHealth	Reimbursement for the Administration of Drugs, Substances, and/or Biologic AgentsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-051	New policy
Aug 2, 2026	AmeriHealth	Reimbursement for Radiopharmaceutical AgentsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA09-009	New policy
Aug 2, 2026	AmeriHealth	Reimbursement for Outpatient Emergency Department Visits [AmeriHealth New Jersey]PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-044-NEW-JERSEY	New policy
Aug 2, 2026	AmeriHealth	Reimbursement for Emergent Inpatient AdmissionsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-059	New policy
Aug 2, 2026	AmeriHealth	Reimbursement for Components of Comprehensive Laboratory PanelsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA01-006	New policy
Aug 2, 2026	AmeriHealth	Reimbursement for Certain Evaluation and Management (E/M) ServicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-049	New policy
Aug 2, 2026	AmeriHealth	Reimbursement for an Intraocular LensPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-043	New policy
Aug 2, 2026	AmeriHealth	Reimbursement For Advanced Practice Provider ServicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-056	New policy
Aug 2, 2026	AmeriHealth	Refractive LensesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA07-029	New policy
Aug 2, 2026	AmeriHealth	Refractive Keratoplasty, Keratoprosthesis, and Corneal Collagen Cross-LinkingPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-008	New policy
Aug 2, 2026	AmeriHealth	Reduction MammoplastyPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-069	New policy
Aug 2, 2026	AmeriHealth	Reconstructive Breast SurgeryPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-030	New policy
Aug 2, 2026	AmeriHealth	Rapid Whole Exome Sequencing (rWES) and Rapid Whole Genome Sequencing (rWGS) for Diagnosis of Genetic DisordersPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA06-035	New policy
Aug 2, 2026	AmeriHealth	Ramucirumab (Cyramza)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-075	New policy
Aug 2, 2026	AmeriHealth	Radiologic Guidance and/or Supervision and Interpretation of a ProcedurePayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-019	New policy
Aug 2, 2026	AmeriHealth	Radiation Therapy Services (AmeriHealth)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA09-020	New policy
Aug 2, 2026	AmeriHealth	Pulse Oximetry Device in the Home SettingPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-042	New policy
Aug 2, 2026	AmeriHealth	Pulmonary RehabilitationPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA10-001	New policy
Aug 2, 2026	AmeriHealth	Psychological TestingPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA14-002	New policy
Aug 2, 2026	AmeriHealth	Psychiatric Collaborative Care Management (CoCM)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-052B-1FF707C1AF	New policy
Aug 2, 2026	AmeriHealth	Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate CancerPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA06-036	New policy
Aug 2, 2026	AmeriHealth	Prophylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and HysterectomyPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-077	New policy
Aug 2, 2026	AmeriHealth	Procedures for the Treatment of Gastroesophageal Reflux Disease (GERD)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-055	New policy
Aug 2, 2026	AmeriHealth	Procedures for the Treatment of AcnePayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-109	New policy
Aug 2, 2026	AmeriHealth	Private Duty NursingPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA02-002	New policy
Aug 2, 2026	AmeriHealth	Preventive Care ServicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-003	New policy
Aug 2, 2026	AmeriHealth	Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management TreatmentsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA06-025	New policy
Aug 2, 2026	AmeriHealth	Pressure-Reducing Support SurfacesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-025	New policy
Aug 2, 2026	AmeriHealth	Prescription Digital Therapeutics and Mobile-Based Health Management ApplicationsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA12-011	New policy
Aug 2, 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	New policy
Aug 2, 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	New policy
Aug 2, 2026	AmeriHealth	Pozelimab-bbfg (Veopoz)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-167	New policy
Aug 2, 2026	AmeriHealth	Power Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Power-Assist System DevicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-032	New policy
Aug 2, 2026	AmeriHealth	Positron Emission Mammography (PEM)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA09-015	New policy
Aug 2, 2026	AmeriHealth	Polatuzumab vedotin-piiq (Polivy)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-108	New policy
Aug 2, 2026	AmeriHealth	Pneumatic Compression Therapy DevicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-004	New policy
Aug 2, 2026	AmeriHealth	Photodynamic Therapy Using Verteporfin (Visudyne)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA07-003	New policy