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REIMBURSEMENT POLICIES

Reimbursement REIMB-003 Status B Bundled Codes October 28, 2024 August 28, 2024 August 28, 2025
Reimbursement reimb-028 After-Hours Codes Coverage March 26, 2025 March 26, 2025 March 26, 2026
Reimbursement REIMB-037 Billing for Gender Discordant Claims January 22, 2025 January 22, 2025 January 22, 2026
Reimbursement REIMB-036 Clinical Trials January 22, 2025 January 22, 2025 January 22, 2026
Reimbursement reimb-020 Custom Diabetic Shoes December 04, 2024 December 04, 2024 December 04, 2025
Reimbursement reimb-030 Durable Medical Equipment (DME) Supplies February 26, 2025 February 26, 2025 February 26, 2026
Reimbursement reimb-035 External Breast Prosthetics January 22, 2025 January 22, 2025 January 22, 2026
Reimbursement reimb-029 Global Maternity Care September 30, 2024 July 31, 2024 July 31, 2025
Reimbursement reimb-010 Home Health Aide Services February 26, 2025 February 26, 2025 February 26, 2026
Reimbursement reimb-016 Intrathecal or Epidural Pump Refill March 26, 2025 March 26, 2025 March 26, 2026
Reimbursement reimb-031 Multiple Procedure Guidelines for Ambulatory Surgical Centers March 26, 2025 March 26, 2025 March 26, 2026
Reimbursement reimb-032 Multiple Procedure Guidelines for Outpatient Hospital Claims March 26, 2025 March 26, 2025 March 26, 2026
Reimbursement reimb-034 Multiple Procedure Payment Reduction (MPPR) July 31, 2024 July 31, 2024 July 31, 2025
Reimbursement reimb-007 Next Generation Sequencing (NGS) Genetic Testing September 04, 2024 September 04, 2024 September 04, 2025
Reimbursement reimb-024 Non-residential Opioid Treatment Facility (Place of Service 58) July 31, 2024 July 31, 2024 July 31, 2025
Reimbursement reimb-025 OB Anesthesia October 23, 2024 October 23, 2024 October 23, 2025
Reimbursement reimb-015 Oral Appliances for Obstructive Sleep Apnea June 26, 2024 June 26, 2024 June 26, 2025
Reimbursement reimb-026 Prolonged Services December 04, 2024 December 04, 2024 December 04, 2025
Reimbursement REIMB-027 Myoelectric Prosthetic Components for the Upper Limb May 13, 2025 March 13, 2025 March 13, 2026
Reimbursement reimb-009 Preventative Care Screening February 26, 2025 February 26, 2025 February 26, 2026
Reimbursement reimb-011 Routine Foot Care February 26, 2025 February 26, 2025 February 26, 2026
Reimbursement reimb-012 Sources for Coding Determinations July 31, 2024 July 31, 2024 July 31, 2025
Reimbursement reimb-013 Developmental Screening and Testing Guidelines September 04, 2024 September 04, 2024 September 04, 2025
Reimbursement reimb-041 Recreational Therapy December 04, 2024 December 04, 2024 December 04, 2025
Reimbursement REIMB-042 Doula Services May 13, 2025 March 13, 2025 March 13, 2026
Reimbursement REIMB-043 Orthotic Supplies July 28, 2025 May 28, 2025 May 28, 2026
Reimbursement REIMB-044 Routine Supplies & Services August 28, 2025 June 25, 2025 June 25, 2026
Reimbursement REIMB-045 Medical/Surgical Supplies August 28, 2025 June 25, 2025 June 25, 2026
Reimbursement REIMB-046 Modifiers August 30, 2025 July 30, 2025 July 30, 2026
Reimbursement REIMB-005 Add-on Codes March 26, 2025 March 26, 2025 March 26, 2026
Reimbursement reimb-008 Miscellaneous Surgical Supplies – A4649 March 23, 2025 March 23, 2025 March 23, 2026
Reimbursement REIMB-040 Unlisted/Miscellaneous Codes November 25, 2024 September 25, 2024 September 25, 2025
Reimbursement REIMB-047 Residential Treatment Center Interim Billing February 01, 2026 January 01, 2026 February 01, 2027