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 | Providence Health Plan | Administrative Guideline for Dental ServicesPayerPolicy · PROVIDENCE-MP-MP186 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | Administrative Guideline for Dental ServicesPayerPolicy · PROVIDENCE-MP-MP162 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 50.0 Modifier -63: Procedures Performed on Infants Less than 4kgPayerPolicy · PROVIDENCE-CODING-PHP-CODING-50 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 42.0 Modifiers – GA, -GY, and -GZ: Non-Covered ServicesPayerPolicy · PROVIDENCE-CODING-PHP-CODING-42 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 39.0 Modifiers -52, -73, and -74: Discontinues Procedures (Outpatient/ASC Facility Charges)PayerPolicy · PROVIDENCE-CODING-PHP-CODING-39 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 35.0 Laboratory Services, Professional ChargesPayerPolicy · PROVIDENCE-CODING-350-LABORATORY-SERVICES-PROFESSIONAL-CHARGES | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 33.0 Modifier 59 and Other Modifiers for Distinct Procedural ServicesPayerPolicy · PROVIDENCE-CODING-PHP-CODING-33 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 32.0 Modifier -57 : Decision for SurgeryPayerPolicy · PROVIDENCE-CODING-PHP-CODING-32 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 31.0 Modifier -25 : Evaluation and Management Same Day as Procedure or Other ServicePayerPolicy · PROVIDENCE-CODING-PHP-CODING-31 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 30.0 Laboratory Panel BillingPayerPolicy · PROVIDENCE-CODING-PHP-CODING-30 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 29.0 Date of Service for Professional ClaimsPayerPolicy · PROVIDENCE-CODING-290-DATE-OF-SERVICE-FOR-PROFESSIONAL-CLAIMS | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 27.0 Unlisted Procedure CodesPayerPolicy · PROVIDENCE-CODING-PHP-CODING-27 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 22.0 HCPCS S-Codes and H- CodesPayerPolicy · PROVIDENCE-CODING-PHP-CODING-22 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 20.0 Modifiers -54, -55, -56: Split Global Surgical PackagePayerPolicy · PROVIDENCE-CODING-PHP-CODING-20 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 14.0 Bilateral ServicesPayerPolicy · PROVIDENCE-CODING-PHP-CODING-14 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 06.2 Multiple Diagnostic Service ReductionsPayerPolicy · PROVIDENCE-CODING-PHP-CODING-06-D-2 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 06.1 Multiple Endoscopy Procedure ReductionsPayerPolicy · PROVIDENCE-CODING-PHP-CODING-06-D-1 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 06.0 Multiple Procedure ReductionsPayerPolicy · PROVIDENCE-CODING-PHP-CODING-06 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 02.0 Diagnosis CodingPayerPolicy · PROVIDENCE-CODING-PHP-CODING-02 | Metadata changed |
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| Aug 1, 2026 | Providence Health Plan | 01.0 General Coding PolicyPayerPolicy · PROVIDENCE-CODING-PHP-CODING-01 | Metadata changed |
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| Aug 1, 2026 | Moda Health | Portrazza (necitumumab)PayerPolicy · MODA-PORTRAZZA-8E9A658899 | Retired |
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| Aug 1, 2026 | Moda Health | Anti-amyloid-β monoclonal antibodies: donanemab-azbt (Kisunla); lecanemab-irmb (Leqembi)PayerPolicy · MODA-ADUHELM-80F82503F2 | Retired |
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| Aug 1, 2026 | Moda Health | Spevigo (spesolimab) SQPayerPolicy · MODA-SPEVIGO-SQ | New policy |
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| Aug 1, 2026 | Moda Health | Loargys (pegzilarginase-nbln)PayerPolicy · MODA-LOARGYS | New policy |
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| Aug 1, 2026 | Moda Health | Exdensur (depemokimab-ulaa)PayerPolicy · MODA-EXDENSUR | New policy |
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| Aug 1, 2026 | Moda Health | Avlayah (tividenofusp alfa-eknm)PayerPolicy · MODA-AVLAYAH | New policy |
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| Aug 1, 2026 | Moda Health | Anti-amyloid-β monoclonal antibodies: donanemab-azbt (Kisunla)PayerPolicy · MODA-ADUHELM | New policy |
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| Aug 1, 2026 | Humana | Implantable Infusion Pumps for Pain or SpasticityPayerPolicy · HUMANA-IMPLANTABLE-INFUSION-PUMPS-FOR-PAIN-OR-SPASTICITY-MA | Retired |
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| Aug 1, 2026 | Humana | Shoulder ArthroplastyPayerPolicy · HUMANA-SHOULDER-ARTHROPLASTY-MA | Retired |
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| Aug 1, 2026 | Humana | Pharmacogenomics TestingPayerPolicy · HUMANA-PHARMACOGENOMICS-TESTING-MA | Retired |
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| Aug 1, 2026 | Humana | Liquid BiopsyPayerPolicy · HUMANA-LIQUID-BIOPSY-MA | Retired |
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| Aug 1, 2026 | Humana | Superficial Radiation TherapyPayerPolicy · HUMANA-SUPERFICIAL-RADIATION-THERAPY-MA | Retired |
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| Aug 1, 2026 | Humana | Injections for Chronic Pain ConditionsPayerPolicy · HUMANA-INJECTIONS-FOR-CHRONIC-PAIN-CONDITIONS-MA | Retired |
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| Aug 1, 2026 | Humana | Gene Expression Profiling for Noncancer IndicationsPayerPolicy · HUMANA-GENE-EXPRESSION-PROFILING-FOR-NONCANCER-INDICATIONS-MA | Retired |
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| Aug 1, 2026 | Humana | Transcatheter and Device-Based Hemodynamic Management ProceduresPayerPolicy · HUMANA-TRANSCATHETER-AND-DEVICE-BASED-HEMODYNAMIC-MANAGEMENT-PROCEDURES-MA | Retired |
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| Aug 1, 2026 | Humana | Genetic and Biomarker Testing for Neurodegenerative DiseasePayerPolicy · HUMANA-GENETIC-AND-BIOMARKER-TESTING-FOR-NEURODEGENERATIVE-DISEASE-MA | Retired |
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| Aug 1, 2026 | Humana | Pediatric Day Health Care (PDHC)PayerPolicy · HUMANA-PEDIATRIC-DAY-HEALTH-CARE-PDHC-LA-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Intrathecal Baclofen TherapyPayerPolicy · HUMANA-INTRATHECAL-BACLOFEN-THERAPY-LA-MEDICAID-EFF-20230101 | Retired |
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| Aug 1, 2026 | Humana | Abortion, Hysterectomy and SterilizationPayerPolicy · HUMANA-ABORTION-HYSTERECTOMY-AND-STERILIZATION-LA-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Personal Care Services (PCS) for Adults with Serious Mental Illness (SMI)PayerPolicy · HUMANA-PERSONAL-CARE-SERVICES-PCS-FOR-ADULTS-WITH-SERIOUS-MENTAL-ILLNESS-SMI-LA-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Community Brief Crisis Support (CBCS)PayerPolicy · HUMANA-COMMUNITY-BRIEF-CRISIS-SUPPORT-CBCS-LA-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Early Periodic Screening Diagnostic Treatment (EPSDT) Personal Care Services (PCS)PayerPolicy · HUMANA-EARLY-PERIODIC-SCREENING-DIAGNOSTIC-TREATMENT-EPSDT-PERSONAL-CARE-SERVICES-PCS-LA-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Tongue Neurostimulation for Obstructive Sleep ApneaPayerPolicy · HUMANA-TONGUE-NEUROSTIMULATION-FOR-OBSTRUCTIVE-SLEEP-APNEA-SC-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Kebilidi (eladocagene exuparvovec-tneq)PayerPolicy · HUMANA-KEBILIDI-ELADOCAGENE-EXUPARVOVEC-TNEQ-SC-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Cosmetic and Reconstructive SurgeryPayerPolicy · HUMANA-COSMETIC-AND-RECONSTRUCTIVE-SURGERY-KY-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Breast ReconstructionPayerPolicy · HUMANA-BREAST-RECONSTRUCTION-KY-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Homebuilders Clinical Coverage PolicyPayerPolicy · HUMANA-HOMEBUILDERS-CLINICAL-COVERAGE-POLICY-LA-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Lenmeldy (atidarsagene autotemcel)PayerPolicy · HUMANA-LENMELDY-ATIDARSAGENE-AUTOTEMCEL-SC-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Lantidra (donislecel)PayerPolicy · HUMANA-LANTIDRA-DONISLECEL-SC-MEDICAID | Retired |
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| Aug 1, 2026 | Humana | Umbilical Cord Blood TransplantationPayerPolicy · HUMANA-UMBILICAL-CORD-BLOOD-TRANSPLANTATION-SC-MEDICAID | Retired |
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