COVERAGE POLICY UPDATES
Reimbursement Policy Updates
University of Utah Health Plans uses medical policies as guidelines for coverage determinations in accordance with the member’s benefits. Quarterly notice of recently approved and revised medical policies is provided in Provider Connection for your convenience. The Medical Policy Updates section of this newsletter does not indicate that coverage is provided for the procedures listed.
| NEW POLICIES | |||
|---|---|---|---|
| Policy Number | Policy Name | Effective Date | Summary |
| REIMB-027 (New) | Myoelectric Prosthetic Components for the Upper Limb | 05/13/2025 | Commercial Plan: U of U Health Plans covers myoelectric prosthetic components for the upper limb in limited circumstances when certain criteria are met. Please see the policy for further details. |
| REIMB-042 (New) | Doula Services | 05/13/2025 | Commercial Plan: U of U Health Plans will provide coverage for doula labor support services in approved settings (hospital or birthing center) to enhance maternal health outcomes and support birthing individuals. Coverage eligibility and reimbursement for doula services will be subject to prior authorization and adherence to approved provider requirements. Please check members Specific Plan Determination (SPD) for coverage services. Please see the policy for further details. |
| REIMB-043 (New) | Orthotic Supplies | 07/28/2025 | Commercial Plan: U of U Health Plans provides coverage for orthotic devices when prescribed by a qualified physician or other qualified health professional and considered medically necessary for therapeutic support, protection, restoration and/or improvement in the function of an impaired body part. Please see the policy for further details. |
| REVISED POLICIES | |||
|---|---|---|---|
| Policy Number | Policy Name | Effective Date | Summary |
| No revised reimbursement policies at this time. | |||