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REIMBURSEMENT POLICIES

Reimbursement reimb-002 Urine Drug Testing in the Outpatient Setting July 31, 2024 July 31, 2024 July 31, 2025
Reimbursement REIMB-003 Status B Bundled Codes October 28, 2024 August 28, 2024 August 28, 2025
Reimbursement reimb-028 After-Hours Codes Coverage March 27, 2024 March 27, 2024 March 27, 2025
Reimbursement REIMB-037 Billing for Gender Discordant Claims January 24, 2024 January 24, 2024 January 24, 2025
Reimbursement REIMB-036 Clinical Trials January 24, 2024 January 24, 2024 January 24, 2025
Reimbursement reimb-020 Custom Diabetic Shoes December 13, 2023 December 13, 2023 December 13, 2024
Reimbursement reimb-030 Durable Medical Equipment (DME) Supplies April 28, 2024 February 28, 2024 February 28, 2025
Reimbursement reimb-035 External Breast Prosthetics January 24, 2024 January 24, 2024 January 24, 2025
Reimbursement reimb-029 Global Maternity Care September 30, 2024 July 31, 2024 July 31, 2025
Reimbursement reimb-010 Home Health Aide Services February 28, 2024 February 28, 2024 February 28, 2025
Reimbursement reimb-016 Intrathecal or Epidural Pump Refill March 27, 2024 March 27, 2024 March 27, 2025
Reimbursement reimb-014 Modifier -25 June 26, 2024 June 26, 2024 June 26, 2025
Reimbursement reimb-021 Modifiers 54, 55, 56 June 26, 2024 June 26, 2024 June 26, 2025
Reimbursement reimb-033 Modifier -63 May 29, 2024 May 29, 2024 May 29, 2025
Reimbursement reimb-006 Modifier -78 December 13, 2023 December 13, 2023 December 13, 2024
Reimbursement reimb-022 Modifier -90 Reference (Outside) Laboratory June 26, 2024 June 26, 2024 June 26, 2025
Reimbursement reimb-031 Multiple Procedure Guidelines for Ambulatory Surgical Centers March 27, 2024 March 27, 2024 March 27, 2025
Reimbursement reimb-032 Multiple Procedure Guidelines for Outpatient Hospital Claims March 27, 2024 March 27, 2024 March 27, 2025
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 13, 2023 December 13, 2023 December 13, 2024
Reimbursement reimb-009 Preventative Care Screening April 28, 2024 February 28, 2024 February 28, 2025
Reimbursement reimb-011 Routine Foot Care February 28, 2024 February 28, 2024 February 28, 2025
Reimbursement reimb-012 Sources for Coding Determinations July 31, 2024 July 31, 2024 July 31, 2025
Reimbursement reimb-018 UC Modifier October 23, 2024 October 23, 2024 October 23, 2025
Reimbursement reimb-013 Developmental Screening and Testing Guidelines September 04, 2024 September 04, 2024 September 04, 2025
Reimbursement reimb-038 Modifier -24 January 06, 2024 November 06, 2023 November 06, 2024
Reimbursement reimb-041 Recreational Therapy January 01, 2024 December 13, 2023 December 13, 2024
Reimbursement reimb-039 Modifier -22 February 13, 2024 December 13, 2023 December 13, 2024
Reimbursement REIMB-005 Add-on Codes May 08, 2024 March 08, 2024 March 08, 2025
Reimbursement reimb-008 Miscellaneous Surgical Supplies – A4649 June 24, 2024 April 24, 2024 April 24, 2025