Policy Name Effective Date Revision Date Next Review Date
Reimbursement
reimb-028 After-Hours Codes Coverage July 01, 2021 April 01, 2021 April 01, 2022
Reimb-020 Custom Diabetic Shoes December 16, 2020 December 16, 2020 December 16, 2021
reimb-030 Durable Medical Equipment (DME) October 06, 2021 August 06, 2021 August 06, 2022
reimb-029 Global Maternity Care August 14, 2021 June 07, 2021 June 07, 2022
Reimb-016 Intrathecal or Epidural Pump Refill April 21, 2021 April 21, 2021 April 21, 2022
Reimb-014 Modifier -25 February 24, 2021 February 24, 2021 February 24, 2022
Reimb-033 Modifier -63 July 24, 2021 May 24, 2021 May 24, 2022
reimb-006 Modifier -78 January 30, 2021 November 30, 2020 November 30, 2021
Reimb-022 Modifier -90 Reference (Outside) Laboratory May 26, 2021 May 26, 2021 May 26, 2022
reimb-031 Multiple Procedure Guidelines for Ambulatory Surgical Centers May 24, 2021 March 24, 2021 March 24, 2022
reimb-032 Multiple Procedure Guidelines for Outpatient Hospital Claims May 24, 2021 March 24, 2021 March 24, 2022
reimb-034 Multiple Procedure Payment Reduction (MPPR) September 01, 2021 July 01, 2021 July 01, 2022
reimb-007 Next Generation Sequencing (NGS) Genetic Testing October 06, 2021 August 6, 2021 August 06, 2022
Reimb-024 Non-residential Opioid Treatment Facility (Place of Service 58) June 23, 2021 June 23, 2021 June 23, 2022
Reimb-025 OB Anesthesia September 28, 2021 September 28, 2021 September 28, 2022
Reimb-015 Oral Appliances for Obstructive Sleep Apnea May 26, 2021 May 26, 2021 May 26, 2022
reimb-026 Prolonged Services September 01, 2021 May 19, 2021 May 19, 2022
Reimb-011 Routine Foot Care March 30, 2021 March 24, 2021 March 24, 2022
Reimb-012 Sources for Coding Determinations July 28, 2021 July 28, 2021 July 28, 2022
Reimb-002 Urine Drug Screen Testing In the Outpatient Setting May 26, 2021 May 26, 2021 May 26, 2022