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 |
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| Aug 1, 2026 | Univera Healthcare | Autologous Chondrocyte Implantation (ACI) (Effective 2026-10-15)PayerPolicy · UNIVERA-7-01-38-FUTURE | New policy |
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| Aug 1, 2026 | Univera Healthcare | Artificial Lumbar Intervertebral DiscPayerPolicy · UNIVERA-7-01-63 | New policy |
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| Aug 1, 2026 | Univera Healthcare | Artificial Lumbar Intervertebral Disc (Effective 2026-10-15)PayerPolicy · UNIVERA-7-01-63-FUTURE | New policy |
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| Aug 1, 2026 | Univera Healthcare | Artificial Cervical Intervertebral DiscPayerPolicy · UNIVERA-7-01-80 | New policy |
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| Aug 1, 2026 | Univera Healthcare | Artificial Cervical Intervertebral Disc (Effective 2026-10-15)PayerPolicy · UNIVERA-7-01-80-FUTURE | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Inpatient Stays: High-cost drug administration protocol - UnitedHealthcare commercial plansPayerPolicy · UHC-PROT-HIGH-COST-DRUG-PROTOCOL | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Site of Service DifferentialPayerPolicy · UHC-OXADM-SITE-OF-SERVICE-DIFFERENTIAL-OHP | Metadata changed |
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| Aug 1, 2026 | UnitedHealthcare | Maximum Frequency Per Day Policy, ProfessionalPayerPolicy · UHC-EXCH-RP-MAXIMUM-FREQUENCY-PER-DAY-POLICY-PROFESS-A691B087B2 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Vitamin B12 Testing Policy Professional and FacilityPayerPolicy · UHC-EXCH-RP-VITAMIN-B12-TESTING-POLICY-PROFESSIONAL-37C87E6E50 | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Testosterone Policy, Professional and FacilityPayerPolicy · UHC-EXCH-RP-COMM-TESTOSTERONE-POLICY | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Maximum Frequency Per DayPayerPolicy · UHC-EXCH-RP-COMM-MAXIMUM-FREQUENCY-PER-DAY-POLICY | New policy |
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| Aug 1, 2026 | UnitedHealthcare | In Vitro Chemotherapy Assays Policy, Professional and FacilityPayerPolicy · UHC-EXCH-RP-COMM-IN-VITRO-CHEMOTHERAPY-ASSAYS-POLICY | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Hepatic Fibrosis Testing for Chronic Liver Disease Policy, Professional and FacilityPayerPolicy · UHC-EXCH-RP-COMM-HEPATIC-FIBROSIS-TESTING-POLICY | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Allergen Testing Policy, Professional and FacilityPayerPolicy · UHC-EXCH-RP-COMM-ALLERGEN-TESTING-POLICY | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Trogarzo (Ibalizumab-Uiyk) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-TROGARZO-IBALIZUMAB-UIYK-INDIVIDUAL-EXCH-22DA727B1B | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Tocilizumab (Actemra, Tofidence, & Tyenne) Injection for Intravenous Infusion – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-TOCILIZUMAB-ACTEMRA-TOFIDENCE-TYENNE-INJ-EEB4337D63 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Synagis (Palivizumab) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-SYNAGIS-PALIVIZUMAB-INDIVIDUAL-EXCHANGE-0318D80D01 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Susvimo (Ranibizumab Injection) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-SUSVIMO-RANIBIZUMAB-INJECTION-INDIVIDUAL-5DE2DE824C | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Surgery of the Hand or WristPayerPolicy · UHC-EXCH-MD-SURGERY-OF-THE-HAND-OR-WRIST-6512FA4CA2 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Spevigo (Spesolimab-Sbzo) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-SPEVIGO-SPESOLIMAB-SBZO-INDIVIDUAL-EXCHA-AAFEC81018 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Skyrizi (Risankizumab-Rzaa) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-SKYRIZI-RISANKIZUMAB-RZAA-INDIVIDUAL-EXC-1EFEE4DDF7 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Scenesse (Afamelanotide) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-SCENESSE-AFAMELANOTIDE-INDIVIDUAL-EXCHAN-077B36D58D | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Saphnelo (Anifrolumab-Fnia) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-SAPHNELO-ANIFROLUMAB-FNIA-INDIVIDUAL-EXC-5EB7A12173 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | RNA-Targeted Therapies (Amvuttra and Onpattro) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-RNA-TARGETED-THERAPIES-AMVUTTRA-AND-ONPA-B929CC5828 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Reblozyl (Luspatercept-Aamt) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-REBLOZYL-LUSPATERCEPT-AAMT-INDIVIDUAL-EX-6BA77805CF | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Oxlumo (Lumasiran) and Rivfloza (Nedosiran) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-OXLUMO-LUMASIRAN-AND-RIVFLOZA-NEDOSIRAN-B0A69D11C0 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Orencia (Abatacept) Injection for Intravenous Infusion – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-ORENCIA-ABATACEPT-INJECTION-FOR-INTRAVEN-FFB386045D | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Off-Label/Unproven Specialty Drug Treatment – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-OFF-LABEL-UNPROVEN-SPECIALTY-DRUG-TREATM-48D22CC433 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Nerve Graft to Restore Erectile Function During Radical ProstatectomyPayerPolicy · UHC-EXCH-MD-NERVE-GRAFT-TO-RESTORE-ERECTILE-FUNCTION-A2D3685163 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Maximum Dosage and Frequency – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-MAXIMUM-DOSAGE-AND-FREQUENCY-INDIVIDUAL-320E4E9568 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Korsuva (Difelikefalin) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-KORSUVA-DIFELIKEFALIN-INDIVIDUAL-EXCHANG-02D763F2FC | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Kebilidi (Eladocagene Exuparvovec-Tneq) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-KEBILIDITM-ELADOCAGENE-EXUPARVOVEC-TNEQ-7BA81299DB | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Intravenous Enzyme Replacement Therapy (ERT) for Gaucher Disease – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-INTRAVENOUS-ENZYME-REPLACEMENT-THERAPY-E-F84D5A9421 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Intracanalicular and Intravitreal Corticosteroid Implants – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-INTRACANALICULAR-AND-INTRAVITREAL-CORTIC-711B209460 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Gene Therapies for Hemophilia B – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-GENE-THERAPIES-FOR-HEMOPHILIA-B-INDIVIDU-0DC7E3ECC0 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Entyvio (Vedolizumab) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-ENTYVIO-VEDOLIZUMAB-INDIVIDUAL-EXCHANGE-68A0440C40 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Encelto (Revakinagene Taroretcel-Lwey) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-ENCELTOTM-REVAKINAGENE-TARORETCEL-LWEY-I-C9ED896D45 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Cytological Examination of Breast Fluids for Cancer Screening or DiagnosisPayerPolicy · UHC-EXCH-MD-CYTOLOGICAL-EXAMINATION-OF-BREAST-FLUIDS-06658E00E5 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Adzynma (ADAMTS13, Recombinant-Krhn) – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-ADZYNMA-ADAMTS13-RECOMBINANT-KRHN-INDIVI-C4A425DEA6 | Retired |
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| Aug 1, 2026 | UnitedHealthcare | Whole Exome and Whole Genome Sequencing (Non-Oncology Conditions)PayerPolicy · UHC-EXCH-MD-WHOLE-EXOME-AND-WHOLE-GENOME-SEQUENCING | Metadata changed |
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| Aug 1, 2026 | UnitedHealthcare | Ustekinumab – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-USTEKINUMAB-IEX | Metadata changed |
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| Aug 1, 2026 | UnitedHealthcare | Umbilical Cord Blood Harvesting and Storage for Future UsePayerPolicy · UHC-EXCH-MD-UMBILICAL-CORD-BLOOD-HARVESTING-AND-STORAGE-FUTURE-USE | Metadata changed |
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| Aug 1, 2026 | UnitedHealthcare | Tzield (Teplizumab-Mzwv) – Commercial and Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-TZIELD | Metadata changed |
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| Aug 1, 2026 | UnitedHealthcare | Trogarzo (Ibalizumab-Uiyk) – Commercial and Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-TROGARZO-IBALIZUMAB-UIYK | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Transcatheter Procedures for Heart Valve ConditionsPayerPolicy · UHC-EXCH-MD-TRANSCATHETER-HEART-VALVE-PROCEDURES | Metadata changed |
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| Aug 1, 2026 | UnitedHealthcare | Tocilizumab Injection for Intravenous Infusion – Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-TOCILIZUMAB-INJECTION-FOR-INTRAVENOUS-INFUSION-IEX | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Susvimo (Ranibizumab Injection) – Commercial and Individual Exchange Medical Benefit Drug PolicyPayerPolicy · UHC-EXCH-MD-SUSVIMO | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Surgical and Ablative Procedures for Venous Insufficiency and Varicose VeinsPayerPolicy · UHC-EXCH-MD-SURGICAL-ABLATIVE-PROCEDURES-VENOUS-INSUFFICIENCY-VARICOSE-VEINS | Metadata changed |
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| Aug 1, 2026 | UnitedHealthcare | Surgery of the Wrist or ThumbPayerPolicy · UHC-EXCH-MD-SURGERY-HAND-WRIST | New policy |
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| Aug 1, 2026 | UnitedHealthcare | Surgery of the KneePayerPolicy · UHC-EXCH-MD-SURGERY-KNEE | Metadata changed |
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