Policy Name Effective Date Revision Date Next Review Date
Administrative
Admin-002 Behavioral Health Services Level of Care Determination August 26, 2020 August 26, 2020 August 26, 2021
Admin-015 Category III CPT Codes June 13, 2020 February 26, 2020 February 26, 2021
Admin-001 Clinical Criteria for Review Determinations November 30, 2020 November 30, 2020 November 30, 2021
Admin-003 Medical Services Level of Care Determination November 30, 2020 November 30, 2020 November 30, 2021
Admin-017 Temporary COVID-19 Telemedicine Policy February 24, 2021 February 23, 2021 August 24, 2021
Admin-006 Women’s Health and Cancer Rights Act Clarification July 22, 2020 July 22, 2020 July 22, 2021
Admin-014 Hospital Acquired Conditions and Never Events December 26, 2020 October 26, 2020 October 26, 2021