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	Nebulizers and Inhalation SolutionsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-007	New policy
Aug 2, 2026	AmeriHealth	Natalizumab (Tysabri) and Related BiosimilarsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-029	New policy
Aug 2, 2026	AmeriHealth	Musculoskeletal ServicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-047T-3F39C24AB1	New policy
Aug 2, 2026	AmeriHealth	Multiple Surgery Payment ReductionPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-032H-91D1904680	New policy
Aug 2, 2026	AmeriHealth	Multiple Procedure Payment Reduction Guidelines for Physical, Occupational, and Speech Therapy ServicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-050	New policy
Aug 2, 2026	AmeriHealth	Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic ServicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA01-005	New policy
Aug 2, 2026	AmeriHealth	Multiple Procedure Payment Reduction (MPPR) Guidelines for Transvaginal and Transabdominal UltrasoundsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-057	New policy
Aug 2, 2026	AmeriHealth	Mosunetuzumab-axgb (Lunsumio)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-158	New policy
Aug 2, 2026	AmeriHealth	Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's DiseasePayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-151	New policy
Aug 2, 2026	AmeriHealth	Molecular DiagnosticsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA06-017	New policy
Aug 2, 2026	AmeriHealth	Mohs Micrographic Surgery (MMS)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-018	New policy
Aug 2, 2026	AmeriHealth	Mogamulizumab-kpkc (Poteligeo)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-102G-5A52F34C14	New policy
Aug 2, 2026	AmeriHealth	Modifiers XE, XP, XS, XU, and 59PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-005	New policy
Aug 2, 2026	AmeriHealth	Modifiers for Shared or Split Surgical Services (Modifiers 54, 55, 56)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-017	New policy
Aug 2, 2026	AmeriHealth	Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and ASPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-015	New policy
Aug 2, 2026	AmeriHealth	Modifiers 26 (Professional Component) and TC (Technical Component)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-011O-423A90A409	New policy
Aug 2, 2026	AmeriHealth	Modifier 79: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative PeriodPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-012	New policy
Aug 2, 2026	AmeriHealth	Modifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative PeriodPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-008	New policy
Aug 2, 2026	AmeriHealth	Modifier 77: Repeat Procedure or Service by Another Physician or Other Qualified Health Care ProfessionalPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-007	New policy
Aug 2, 2026	AmeriHealth	Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care ProfessionalPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-001	New policy
Aug 2, 2026	AmeriHealth	Modifier 66: Surgical TeamPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-014	New policy
Aug 2, 2026	AmeriHealth	Modifier 62: Two SurgeonsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-011	New policy
Aug 2, 2026	AmeriHealth	Modifier 57:  Decision for SurgeryPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-010	New policy
Aug 2, 2026	AmeriHealth	Modifier 53: Discontinued ProcedurePayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-018	New policy
Aug 2, 2026	AmeriHealth	Modifier 52: Reduced ServicesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-014	New policy
Aug 2, 2026	AmeriHealth	Modifier 50: Bilateral ProcedurePayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-002	New policy
Aug 2, 2026	AmeriHealth	Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other ServicePayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-003	New policy
Aug 2, 2026	AmeriHealth	Modifier 24: Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative PeriodPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA03-009	New policy
Aug 2, 2026	AmeriHealth	Mirvetuximab soravtansine-gynx (Elahere)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-159	New policy
Aug 2, 2026	AmeriHealth	Mirikizumab-mrkz (Omvoh) for Intravenous UsePayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-169	New policy
Aug 2, 2026	AmeriHealth	Migraine Deactivation SurgeryPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-098	New policy
Aug 2, 2026	AmeriHealth	Mentoplasty or GenioplastyPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-080	New policy
Aug 2, 2026	AmeriHealth	Medicare Part B vs. Part D Crossover DrugsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-007AW-791410F6C9	New policy
Aug 2, 2026	AmeriHealth	Medical NecessityPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA12-008C-B7E7CA6D46	New policy
Aug 2, 2026	AmeriHealth	Medical and Surgical Treatment of Temporomandibular Joint DisorderPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA07-024	New policy
Aug 2, 2026	AmeriHealth	Mechanical Stretching Devices for the Treatment of Joint Stiffness or ContracturesPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-043	New policy
Aug 2, 2026	AmeriHealth	Measurement of Serum Antibodies to and Measurement of Serum Levels of BiologicsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA06-019C-B4C0D76708	New policy
Aug 2, 2026	AmeriHealth	Measurement of Exhaled Nitric Oxide and Breath Condensate in the Diagnosis and Management of Asthma and Other Respiratory DisordersPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA07-044	New policy
Aug 2, 2026	AmeriHealth	Marijuana for Medical UsePayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA00-038	New policy
Aug 2, 2026	AmeriHealth	Margetuximab-cmkb (Margenza)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-132	New policy
Aug 2, 2026	AmeriHealth	Manual WheelchairsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA05-026	New policy
Aug 2, 2026	AmeriHealth	Manipulation Under AnesthesiaPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA11-091	New policy
Aug 2, 2026	AmeriHealth	Magnetic Resonance Imaging (MRI)-Guided Focused Ultrasound AblationPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA09-021	New policy
Aug 2, 2026	AmeriHealth	Magnetic Resonance Imaging (MRI) Contrast AgentsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA09-010	New policy
Aug 2, 2026	AmeriHealth	Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic TherapyPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA06-006	New policy
Aug 2, 2026	AmeriHealth	Luspatercept–aamt (Reblozyl)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-110	New policy
Aug 2, 2026	AmeriHealth	Lurbinectedin (Zepzelca)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-125	New policy
Aug 2, 2026	AmeriHealth	Lumasiran (Oxlumo)PayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-131C-4A88263B5B	New policy
Aug 2, 2026	AmeriHealth	Low Osmolar Contrast AgentsPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA09-008	New policy
Aug 2, 2026	AmeriHealth	Low-Level Laser TherapyPayerPolicy · AMERIHEALTH-MEDICARE-ADVANTAGE-MA07-036	New policy