Preventive Services for Non-Grandfathered (PPACA) Plans: USPSTF Recommended Services

Medicine | January 1, 2024

Hematopoietic Stem-Cell Transplantation for Non-Hodgkin Lymphomas

Therapy | January 1, 2024

Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia

Therapy | January 1, 2024

Allergy Immunotherapy

Medicine | January 1, 2024

Anesthesia Services

Other | January 1, 2024

Neuromuscular Electrical Stimulation (NMES)

Durable Medical Equipment | January 1, 2024

Influenza Vaccine

Medicine | January 1, 2024

Human Papillomavirus (HPV) Vaccines

Medicine | January 1, 2024

Measurement of Thromboxane Metabolites for Aspirin Resistance

Laboratory | January 1, 2024

Blepharoplasty (Upper and Lower)

Surgery | January 1, 2024

Genetic Testing for Cystic Fibrosis

Laboratory | January 1, 2024

Suit Therapy

Therapy | January 1, 2024

Breast Pumps

Durable Medical Equipment | January 1, 2024

Amniotic Membrane and Limbal Stem Cell Transplantation for the Treatment of Ocular Conditions

Surgery | January 1, 2024

Daily Hemodialysis and Hemodialysis in the Home Setting

Therapy | January 1, 2024

Allergen Testing

Laboratory | January 1, 2024

Clinical Trials

Medicine | January 1, 2024

Orthodontic Treatment

Medicine | January 1, 2024

Chiropractic Services

Other | January 1, 2024

Treatment of Chest Wall Deformities (Congenital or Acquired)

Surgery | January 1, 2024

Concurrent Care

Medicine | January 1, 2024

Cell Transplantation (Mesencephalic, Adrenal-Brain and Fetal Xenograft)

Medicine | January 1, 2024

Oral Screening and Testing

Laboratory | January 1, 2024

Discarded Drugs/Biologicals - Pharmaceutical Waste

Medicine | January 1, 2024

Breast Surgical Procedures/Prosthesis

Surgery | January 1, 2024

Cosmetic/Reconstructive Services

Surgery | January 1, 2024

Pegloticase (Krystexxa)

Prescription Drug | January 1, 2024

Preventive Services for Non-Grandfathered (PPACA) Plans: Behavioral Counseling for Prevention

Medicine | January 1, 2024

Robotic Assisted Surgery — Reimbursement Policy

Surgery | January 1, 2024

Women's Preventive Services

Medicine | January 1, 2024

Diagnostic Testing of Iron Homeostasis & Metabolism

Laboratory | January 1, 2024

Ambulance and Medical Transport Services

Other | January 1, 2024

Patient-Controlled Analgesia

Medicine | January 1, 2024

Automated Ambulatory Blood Pressure Monitoring for the Diagnosis of Hypertension in Patients With Elevated Office Blood Pressure

Durable Medical Equipment | January 1, 2024

Low-Intensity Pulsed Ultrasound Fracture Healing Device

Durable Medical Equipment | January 1, 2024

Home Cardiorespiratory Monitoring

Durable Medical Equipment | January 1, 2024

Home Phototherapy for Neonatal Jaundice

Durable Medical Equipment | January 1, 2024

Transcutaneous Electrical Nerve Stimulation (TENS)

Durable Medical Equipment | January 1, 2024

Continuous Passive Motion (CPM) in the Home Setting

Durable Medical Equipment | January 1, 2024

Oxygen Therapy

Durable Medical Equipment | January 1, 2024

Home Prothrombin Time Monitoring

Durable Medical Equipment | January 1, 2024

Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Conditions

Durable Medical Equipment | January 1, 2024

Negative Pressure Wound Therapy in the Outpatient Setting

Durable Medical Equipment | January 1, 2024

Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence

Durable Medical Equipment | January 1, 2024

Pneumatic Compression Pumps for Treatment of Lymphedema

Durable Medical Equipment | January 1, 2024

Skin Contact Monochromatic Infrared Energy as a Technique To Treat Cutaneous Ulcers, Diabetic Neuropathy and Miscellaneous Musculoskeletal Conditions

Durable Medical Equipment | January 1, 2024

Transtympanic Micropressure Applications as a Treatment of Meniere’s Disease

Durable Medical Equipment | January 1, 2024

Interferential Current Stimulation

Durable Medical Equipment | January 1, 2024

Cooling Devices Used in the Outpatient Setting

Durable Medical Equipment | January 1, 2024

Electrical and Electromagnetic Stimulation for the Treatment of Arthritis

Durable Medical Equipment | January 1, 2024

Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis

Durable Medical Equipment | January 1, 2024

Tumor Treating Fields Therapy

Medicine | January 1, 2024

Artificial Pancreas Device Systems

Medicine | January 1, 2024

Total Parenteral Nutrition in the Home

Durable Medical Equipment | January 1, 2024

Powered Exoskeleton for Ambulation in Patients With Lower-Limb Disabilities

Durable Medical Equipment | January 1, 2024

Patient-Controlled End of Range Motion Stretching Devices

Durable Medical Equipment | January 1, 2024

Myoelectric Prosthesis Components for the Upper Limb

Durable Medical Equipment | January 1, 2024

Microprocessor-Controlled Prosthetic for the Lower Limb

Durable Medical Equipment | January 1, 2024

Abdominoplasty, Panniculectomy and Lipectomy

Surgery | January 1, 2024

Preventive Services for Non-Grandfathered (PPACA) Plans: Immunizations

Other | January 1, 2024

Preimplantation Genetic Testing

Laboratory | January 1, 2024

Durable Medical Equipment (DME)

Durable Medical Equipment | January 1, 2024

External Insulin Infusion Pump

Durable Medical Equipment | January 1, 2024

Prenatal Screening (Nongenetics)

Laboratory | January 1, 2024

Flow Cytometry

Laboratory | January 1, 2024

Vitamin D Testing

Laboratory | January 1, 2024

Hepatitis Testing

Laboratory | January 1, 2024

Biomarker Testing for Autoimmune Rheumatic Disease

Laboratory | January 1, 2024

Vitamin B12 and Methylmalonic Acid Testing

Laboratory | January 1, 2024

Testosterone

Laboratory | January 1, 2024

Diabetes Mellitus Testing

Laboratory | January 1, 2024

Diagnostic Testing of Influenza

Laboratory | January 1, 2024

Thyroid Disease Testing

Laboratory | January 1, 2024

Epidural Spinal Injections

Therapy | January 1, 2024

Paravertebral Facet Joint Injections/Blocks

Surgery | January 1, 2024

Corporate Administrative/Medical Policy Guidelines (Medical Necessity, Investigational/Experimental)

Other | January 1, 2024

Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction Due to Benign Prostatic Hyperplasia (BPH)

Surgery | January 1, 2024

Prescription Medication and Illicit Drug Testing in the Outpatient Setting

Laboratory | January 1, 2024

Cervical Spine Procedures

Surgery | January 1, 2024

Knee Braces, Orthopaedic Casts, Splints

Durable Medical Equipment | January 1, 2024

Quantose Impaired Glucose Tolerance (IGT) Test

Laboratory | January 1, 2024

Hypothermia To Prevent/Reduce Hair Loss During Chemotherapy

Medicine | January 1, 2024

InflammaDry Test

Laboratory | January 1, 2024

Medical Policy Development and Review

Other | January 1, 2024

SPECT/CT Fusion Imaging

Radiology | January 1, 2024

Lyme Disease Testing

Laboratory | January 1, 2024

Lumbar Spinal Procedures

Surgery | January 1, 2024

Testing of Homocysteine Metabolism-Related Conditions

Laboratory | January 1, 2024

General Genetic Testing, Germline Disorders

Laboratory | January 1, 2024

General Genetic Testing, Somatic Disorders

Laboratory | January 1, 2024

Genetic Testing for Polyposis Syndromes

Laboratory | January 1, 2024

Lynch Syndrome Testing

Laboratory | January 1, 2024

Fractional Flow Reserve CT

Radiology | January 1, 2024

Pathogen Panel Testing

Laboratory | January 1, 2024

Cardiovascular Disease Risk Assessment

Laboratory | January 1, 2024

Medical Records Documentation Standards

Other | January 1, 2024

Serum Testing for Evidence of Mild Traumatic Brain Injury

Laboratory | January 1, 2024

Biomarkers for Myocardial Infarction and Chronic Heart Failure

Laboratory | January 1, 2024

Pancreatic Enzyme Testing for Acute Pancreatitis

Laboratory | January 1, 2024

Folate Testing

Laboratory | January 1, 2024

Dynamic Posturography

Medicine | January 1, 2024

Hyperbaric Oxygen Therapy

Medicine | January 1, 2024

Local or Whole Body Hyperthermia

Medicine | January 1, 2024

Hypnosis

Medicine | January 1, 2024

Dry Needling for Myofascial Pain

Surgery | January 1, 2024

Vestibular Function Testing

Laboratory | January 1, 2024

Recombinant and Autologous Platelet-Derived Growth Factors for Wound Healing and Other Non-Orthopedic Conditions

Medicine | January 1, 2024

Sublingual Immunotherapy as a Technique of Allergen-Specific Therapy

Medicine | January 1, 2024

Diagnosis of Obstructive Sleep Apnea Syndrome

Medicine | January 1, 2024

Esophageal pH Monitoring

Medicine | January 1, 2024

Temporomandibular Joint Dysfunction

Medicine | January 1, 2024

Prolotherapy

Medicine | January 1, 2024

Biofeedback as a Treatment of Urinary Incontinence in Adults

Medicine | January 1, 2024

Neurofeedback

Medicine | January 1, 2024

Biofeedback as a Treatment of Headache

Medicine | January 1, 2024

Biofeedback as a Treatment of Chronic Pain

Medicine | January 1, 2024

Home Spirometry

Medicine | January 1, 2024

Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain

Medicine | January 1, 2024

Transesophageal Endoscopic Therapies for Gastroesophageal Reflux Disease

Medicine | January 1, 2024

Quantitative Sensory Testing

Medicine | January 1, 2024

Extracorporeal Shock Wave Treatment for Plantar Faciitis and Other Musculoskeletal Conditions

Durable Medical Equipment | January 1, 2024

Chronic Intermittent Intravenous Insulin Therapy (CIIIT)

Therapy | January 1, 2024

Dermatologic Applications of Photodynamic Therapy

Medicine | January 1, 2024

Biofeedback for Miscellaneous Indications

Medicine | January 1, 2024

Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms)

Medicine | January 1, 2024

Low-Level Laser Therapy

Medicine | January 1, 2024

Electrostimulation and Electromagnetic Therapy for the Treatment of Chronic Wounds

Surgery | January 1, 2024

Biofeedback as a Treatment of Fecal Incontinence or Constipation

Medicine | January 1, 2024

Non-Pharmacologic Treatment of Rosacea

Medicine | January 1, 2024

Actigraphy

Medicine | January 1, 2024

Percutaneous Treatment of Fracture Non-Unions or Bone Defects With Autologous Bone Marrow With or Without Demineralized Bone Matrix (DBM)

Medicine | January 1, 2024

Automated Point-of-Care Nerve Conduction Tests

Medicine | January 1, 2024

Non-Contact Ultrasound Treatment of Wounds

Medicine | January 1, 2024

Endoscopic Radiofrequency Ablation or Cryoablation for Barrett's Esophagus

Medicine | January 1, 2024

Ingestible pH and Pressure Capsule

Medicine | January 1, 2024

Bioimpedance Devices for Detection and Management of Lymphedema

Medicine | January 1, 2024

Interventions for Progressive Scoliosis

Medicine | January 1, 2024

Chromoendoscopy as an Adjunct to Colonoscopy

Medicine | January 1, 2024

Neural Therapy

Medicine | January 1, 2024

Confocal Laser Endomicroscopy

Medicine | January 1, 2024

Laser Treatment of Onychomycosis

Medicine | January 1, 2024

Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia

Medicine | January 1, 2024

Fecal Microbiota Transplantation

Medicine | January 1, 2024

Autonomic Nervous System Testing

Medicine | January 1, 2024

Orthopedic Applications of Platelet-Rich Plasma

Medicine | January 1, 2024

Polysomnography for Nonrespiratory Sleep Disorders

Medicine | January 1, 2024

Catheter Ablation for Cardiac Arrhythmias

Medicine | January 1, 2024

Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry

Medicine | January 1, 2024

Biventricular Pacemakers (Cardiac Resynchronization Therapy) for the Treatment of Heart Failure

Medicine | January 1, 2024

Wearable Cardioverter Defibrillators

Medicine | January 1, 2024

Catheter Ablation as Treatment for Atrial Fibrillation

Medicine | January 1, 2024

Ultrafiltration in Decompensated Heart Failure

Medicine | January 1, 2024

Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting

Durable Medical Equipment | January 1, 2024

Percutaneous Left-Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation

Medicine | January 1, 2024

Transcatheter Mitral Valve Repair

Medicine | January 1, 2024

Myocardial Strain Imaging

Medicine | January 1, 2024

Leadless Cardiac Pacemakers

Medicine | January 1, 2024

Donor Lymphocyte Infusion for Malignancies Treated With an Allogeneic Hematopoietic Cell Transplant

Medicine | January 1, 2024

Hyperthermic Intraperitoneal Chemotherapy for Select Intra-Abdominal and Pelvic Malignancies

Medicine | January 1, 2024

Gene Therapy for Inherited Retinal Dystrophy/Luxturna™

Prescription Drug | January 1, 2024

Multianalyte Assays with Algorithmic Analyses for Predicting Risk of Type 2 Diabetes

Medicine | January 1, 2024

General Inflammation Testing

Laboratory | January 1, 2024

Urine Culture Testing for Bacteria

Laboratory | January 1, 2024

Diagnostic Testing of Most Common Sexually Transmitted Infections

Laboratory | January 1, 2024

Testing for Vector-Borne Infections

Laboratory | January 1, 2024

β-Hemolytic Streptococcus Testing

Laboratory | January 1, 2024

Intracardiac Ischemia Monitoring

Medicine | January 1, 2024

Genetic Testing for Duchenne, Becker, Facioscapulohumeral and Limb-Girdle Muscular Dystrophies

Laboratory | January 1, 2024

Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing

Laboratory | January 1, 2024

Pharmacogenetic Testing

Laboratory | January 1, 2024

Zolgensma® (Onasemnogene Abeparvovec-Xioi)

Prescription Drug | January 1, 2024

Home Health Services Policy

Medicine | January 1, 2024

BioZorb®

Surgery | January 1, 2024

Genicular Nerve Blocks and Ablation for Chronic Knee Pain

Medicine | January 1, 2024

Hospice Care

Other | January 1, 2024

Genetic Testing for Neurodegenerative Disorders

Laboratory | January 1, 2024

Laboratory Guideline Policy

Laboratory | January 1, 2024

Therapeutic Drug Monitoring for 5-Fluorouracil

Laboratory | January 1, 2024

Speech Generating Devices

Durable Medical Equipment | January 1, 2024

Proteogenomic Testing of Individuals With Cancer

Laboratory | January 1, 2024

Gene Expression Profiling and Protein Biomarkers for Prostate Cancer

Laboratory | January 1, 2024

Esophageal Pathology Testing

Laboratory | January 1, 2024

Onychomycosis Testing

Laboratory | January 1, 2024

Ambulatory or Video Electroencephalogram (EEG) Monitoring, Including Digital Analysis of Electroencephalogram

Medicine | January 1, 2024

Gamma-Glutamyl Transferase

Laboratory | January 1, 2024

Red Blood Cell Molecular Testing

Laboratory | January 1, 2024

Hospital Medical Services (Inpatient and Observation) and Consultation

Medicine | January 1, 2024

Minimal Residual Disease

Laboratory | January 1, 2024

Bowel Management Devices

Medicine | January 1, 2024

Surgical Treatments for Lymphedema and Lipedema

Surgery | January 1, 2024

Prenatal Testing for Fetal Aneuploidy

Laboratory | January 1, 2024

Molecular Testing for Cutaneous Melanoma

Laboratory | January 1, 2024

Genetic Testing for Germline Mutations of the RET Proto-Oncogene

Laboratory | January 1, 2024

Genetic Testing of Mitochondrial Disorders

Laboratory | January 1, 2024

Testing for Autism Spectrum Disorder and Developmental Delay

Laboratory | January 1, 2024

Genetic Testing for Hereditary Hemochromatosis

Laboratory | January 1, 2024

Genetic Testing for Breast, Ovarian, Pancreatic and Prostate Cancers

Laboratory | January 1, 2024

Teprotumumab-trbw (TEPEZZA™)

Prescription Drug | January 1, 2024

Vectra DA Blood Test for Rheumatoid Arthritis

Laboratory | January 1, 2024

Genetic Testing for Epilepsy

Laboratory | January 1, 2024

Diagnosis and Management of Idiopathic Environmental Intolerance (i.e., Clinical Ecology)

Laboratory | January 1, 2024

Urinary Tumor Markers for Bladder Cancer

Laboratory | January 1, 2024

Intracellular Micronutrient Analysis

Laboratory | January 1, 2024

Testing for Diagnosis of Helicobacter Pylori

Laboratory | January 1, 2024

Fibromyalgia Testing

Laboratory | January 1, 2024

Liquid Biopsy

Laboratory | January 1, 2024

Cluneal Nerve Block for Treatment of Low Back Pain

Medicine | January 1, 2024

Genetic Testing for Inherited Cardiomyopathies and Channelopathies

Laboratory | January 1, 2024

Serum Tumor Markers for Malignancies

Laboratory | January 1, 2024

Molecular Diagnostics for Breast Cancer Prognosis

Laboratory | January 1, 2024

Molecular Markers in Fine Needle Aspirates of the Thyroid

Laboratory | January 1, 2024

Mutation Analysis in Myeloproliferative Neoplasms

Laboratory | January 1, 2024

Genetic Testing for Connective Tissue Disorders

Laboratory | January 1, 2024

Human Immunodeficiency Virus Testing

Laboratory | January 1, 2024

Venous and Arterial Thrombosis Risk Testing

Laboratory | January 1, 2024

Genetic Testing for Alzheimer’s Disease

Laboratory | January 1, 2024

Testing for Targeted Therapy of Non-Small-Cell Lung Cancer

Laboratory | January 1, 2024

Whole Genome and Whole Exome Sequencing

Laboratory | January 1, 2024

Genetic Testing for Neurofibromatosis and Related Disorders

Laboratory | January 1, 2024

Pancreatic Cancer Risk Testing Using Pancreatic Cyst Fluid

Laboratory | January 1, 2024

Genetic Testing for Hereditary Hearing Loss

Laboratory | January 1, 2024

Genetic Testing for Alpha- and Beta-Thalassemia

Laboratory | January 1, 2024

Molecular Profiling for Cancers of Unknown Primary Origin

Laboratory | January 1, 2024

Genetic Testing for the Diagnosis of Inherited Peripheral Neuropathies

Laboratory | January 1, 2024

Genetic Testing for Lactase Insufficiency

Laboratory | January 1, 2024

Genetic Testing for Ophthalmologic Conditions

Laboratory | January 1, 2024

Quantitative Electroencephalography as a Diagnostic Aid for Attention-Deficit/Hyperactivity Disorder

Mental Health | January 1, 2024

Identification of Microorganisms Using Nucleic Acid Probes

Laboratory | January 1, 2024

Genetic Testing for Li-Fraumeni Syndrome

Laboratory | January 1, 2024

Testing for Colorectal Cancer Management

Laboratory | January 1, 2024

Testing for Alpha-1 Antitrypsin Deficiency

Laboratory | January 1, 2024

Genetic Testing for Hereditary Pancreatitis

Laboratory | January 1, 2024

Genetic Testing for PTEN Hamartoma Tumor Syndrome

Laboratory | January 1, 2024

Chromosomal Microarray

Laboratory | January 1, 2024

Cervical Cancer Screening Technologies With Pap and HPV

Laboratory | January 1, 2024

Celiac Disease Testing

Laboratory | January 1, 2024

Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing

Laboratory | January 1, 2024

In Vitro Chemoresistance and Chemosensitivity Assays

Laboratory | January 1, 2024

Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease

Laboratory | January 1, 2024

Nerve Fiber Density Testing

Laboratory | January 1, 2024

Genetic Testing for Familial Hypercholesterolemia

Laboratory | January 1, 2024

Epithelial Cell Cytology in Breast Cancer Risk Assessment and High-Risk Patient Management (Ductal Lavage and Suction Collection Systems)

Laboratory | January 1, 2024

Immune Cell Function Assay

Laboratory | January 1, 2024

Immunopharmacologic Monitoring of Therapeutic Serum Antibodies

Laboratory | January 1, 2024

Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases

Laboratory | January 1, 2024

Use of Common Genetic Variants (Single Nucleotide Polymorphisms) To Predict Risk of Nonfamilial Breast Cancer

Laboratory | January 1, 2024

Molecular Testing of Pulmonary Specimens

Laboratory | January 1, 2024

Bone Turnover Markers Testing

Laboratory | January 1, 2024

Transplant Rejection Testing

Laboratory | January 1, 2024

Metabolite Markers of Thiopurines Testing

Laboratory | January 1, 2024

Prostate Biopsy Specimen Analysis

Surgery | January 1, 2024

Noninvasive Techniques for the Evaluation and Monitoring of Patients With Chronic Liver Disease

Laboratory | January 1, 2024

Genetic Testing and Genetic Expression Profiling in Patients With Uveal Melanoma

Laboratory | January 1, 2024

Intravenous Iron

Prescription Drug | January 1, 2024

Biochemical Markers of Alzheimer Disease and Dementia

Laboratory | January 1, 2024

Testing for Diagnosis of Active or Latent Tuberculosis

Laboratory | January 1, 2024

Molecular Analysis for Gliomas

Laboratory | January 1, 2024

Microsatellite Instability and Tumor Mutational Burden Testing

Laboratory | January 1, 2024

Genetic Testing for CHARGE Syndrome

Laboratory | January 1, 2024

Genetic Testing for Lipoprotein A Variant as a Decision Aid for Aspirin Treatment and/or CVD Risk Assessment

Laboratory | January 1, 2024

Genetic Testing for Fanconi Anemia

Laboratory | January 1, 2024

Genetic Testing of CADASIL Syndrome

Laboratory | January 1, 2024

Genetic Testing for Rett Syndrome

Laboratory | January 1, 2024

Genetic Testing for FMR1 Mutations (including Fragile X Syndrome)

Laboratory | January 1, 2024

Nusinersen for Spinal Muscular Atrophy

Prescription Drug | January 1, 2024

Maternity/Obstetrical Care Benefits

Other | January 1, 2024

Occlusion of Uterine Arteries Using Transcatheter Embolization

Ob/Gyn/Reproduction | January 1, 2024

Progesterone Therapy as a Technique To Reduce Preterm Delivery in High-Risk Pregnancies

Ob/Gyn/Reproduction | January 1, 2024

Ovarian and Internal Iliac Vein Endovascular Occlusion as a Treatment of Pelvic Congestion Syndrome

Ob/Gyn/Reproduction | January 1, 2024

Laparoscopic, Percutaneous and Transcervical Techniques for Uterine Fibroids Myolysis

Ob/Gyn/Reproduction | January 1, 2024

Uterus Transplantation for Absolute Uterine Factor Infertility

Medicine | January 1, 2024

Pain Management Services (Chronic Pain and Rehabilitation Therapies)

Medicine | January 1, 2024

Registered Nurses Practicing in Extended Roles

Other | January 1, 2024

Inpatient Rehabilitation

Therapy | January 1, 2024

Laboratory/Pathology Services

Laboratory | January 1, 2024

Ado-Trastuzumab Emtansine (Trastuzumab-DM1) for Treatment of HER-2 Positive Malignancies

Prescription Drug | January 1, 2024

Radiation Oncology Services

Medicine | January 1, 2024

Radiopharmaceutical Agents and Other In Vivo Diagnostic Aids

Radiology | January 1, 2024

Salivary Hormone Testing

Laboratory | January 1, 2024

Surgical Guidelines (Secondary, Multiple Procedures, Co-Surgeons, Assistant Surgeons, Standby Physicians, Microsurgery/Microdissection)

Surgery | January 1, 2024

Bone Mineral Density Studies

Radiology | January 1, 2024

Miscellaneous (Noncardiac, Nononcologic) Applications of Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography

Radiology | January 1, 2024

Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

Radiology | January 1, 2024

Thermography

Radiology | January 1, 2024

Scintimammography and Gamma Imaging of the Breast and Axilla

Radiology | January 1, 2024

Diagnosis and Non-Surgical Treatment of Sacroiliac Joint Pain

Radiology | January 1, 2024

Minimally Invasive Approaches to Vertebral Fractures and Osteolytic Lesions of the Spine

Radiology | January 1, 2024

FDG Using Camera-Based Imaging (FDG-SPECT)

Radiology | January 1, 2024

Wireless Capsule Endoscopy for Gastrointestinal (GI) Disorders

Radiology | January 1, 2024

Whole Body Dual X-Ray Absorptiometry (DEXA) To Determine Body Composition

Radiology | January 1, 2024

Vertebral Fracture Assessment with Densitometry

Radiology | January 1, 2024

Dynamic Spinal Visualization and Vertebral Motion Analysis

Radiology | January 1, 2024

Positional Magnetic Resonance Imaging (MRI)

Radiology | January 1, 2024

Use of Magnetic Resonance Imaging To Monitor Integrity of Silicone Gel-Filled Breast Implants

Radiology | January 1, 2024

Interim Positron Emission Tomography Scanning in Oncology To Detect Early Response During Treatment

Radiology | January 1, 2024

Digital Breast Tomosynthesis

Radiology | January 1, 2024

Dopamine Transporter Imaging With Single Photon Emission Computed Tomography (DAT-SPECT)

Radiology | January 1, 2024

Myocardial Sympathetic Innervation Imaging in Patients With Heart Failure

Radiology | January 1, 2024

Radioactive Seed Localization of Nonpalpable Breast Lesions

Radiology | January 1, 2024

Endobronchial Ultrasound for Diagnosis and Staging of Lung Cancer

Radiology | January 1, 2024

Therapeutic Radiopharmaceuticals for Neuroendocrine Tumors

Therapy | January 1, 2024

Neck CTA

Radiology | January 1, 2024

MR Angiography Upper Extremity

Radiology | January 1, 2024

Acupuncture and Dry Needling

Surgery | January 1, 2024

Cochlear Implant

Surgery | January 1, 2024

Electrical Bone Growth Stimulation of the Appendicular Skeleton

Surgery | January 1, 2024

Risk-Reducing Mastectomy

Surgery | January 1, 2024

Bone Morphogenetic Protein

Surgery | January 1, 2024

Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome

Surgery | January 1, 2024

Periureteral Bulking Agents for the Treatment of Vesicoureteral Reflux (VUR)

Surgery | January 1, 2024

Surgical Ventricular Restoration

Surgery | January 1, 2024

Subtalar Arthroereisis and Subtalar Joint Implant

Durable Medical Equipment | January 1, 2024

Balloon Ostial Dilation for Treatment of Chronic and Recurrent Acute Rhinosinusitis

Surgery | January 1, 2024

Percutaneous Tibial Nerve Stimulation

Surgery | January 1, 2024

Interspinous and Interlaminar Stabilization/Distraction Devices Spacers

Durable Medical Equipment | January 1, 2024

Magnetic Resonance — Guided Focused Ultrasound

Surgery | January 1, 2024

Vertical Expandable Prosthetic Titanium Rib

Surgery | January 1, 2024

Transanal Endoscopic Microsurgery (TEMS)

Surgery | January 1, 2024

Reverse Shoulder Arthroplasty

Surgery | January 1, 2024

Paravertebral Facet Joint Denervation (Radiofrequency Neurolysis)

Surgery | January 1, 2024

Arthroscopic Debridement and Lavage as Treatment for Osteoarthritis of the Knee

Surgery | January 1, 2024

Surgical Treatment of Femoroacetabular Impingement

Surgery | January 1, 2024

Facet Arthroplasty

Surgery | January 1, 2024

Electromagnetic Navigation Bronchoscopy

Surgery | January 1, 2024

Plugs for Fistula Repair

Surgery | January 1, 2024

Treatment of Varicose Veins/Venous Insufficiency

Surgery | January 1, 2024

Implantable Peripheral Nerve Stimulators for the Treatment of Chronic Pain

Surgery | January 1, 2024

Image-Guided Minimally Invasive Lumbar Decompression (IG-MLD) for Spinal Stenosis

Surgery | January 1, 2024

Bronchial Thermoplasty

Surgery | January 1, 2024

Bronchial Valves

Surgery | January 1, 2024

Surgical Treatment of Bilateral Gynecomastia

Surgery | January 1, 2024

Axial Lumbosacral Interbody Fusion

Surgery | January 1, 2024

Transcatheter Pulmonary Valve Implantation

Surgery | January 1, 2024

Transcatheter Aortic-Valve Implantation for Aortic Stenosis

Surgery | January 1, 2024

Microwave Tumor Ablation

Surgery | January 1, 2024

Steroid-Eluting Sinus Stents and Implants

Surgery | January 1, 2024

Surgical and Ablative Treatments for Chronic Headaches

Surgery | January 1, 2024

Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Resistant Hypertension

Surgery | January 1, 2024

Interspinous Fixation (Fusion) Devices

Surgery | January 1, 2024

Peripheral Subcutaneous Field Stimulation

Surgery | January 1, 2024

Open and Thoracoscopic Approaches To Treat Atrial Fibrillation and Atrial Flutter (Maze and Related Procedures)

Surgery | January 1, 2024

Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery

Surgery | January 1, 2024

Surgery for Groin Pain in Athletes

Surgery | January 1, 2024

Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy

Medicine | January 1, 2024

Patient-Specific Instrumentation (e.g., Cutting Guides) for Joint Arthroplasty

Surgery | January 1, 2024

Amniotic Membrane and Amniotic Fluid Injections for Non-Ophthalmic Applications

Surgery | January 1, 2024

Meniscal Allografts and Other Meniscal Implants

Surgery | January 1, 2024

Adipose-Derived Stem Cells in Autologous Fat Grafting to the Breast

Surgery | January 1, 2024

Ablation of Peripheral Nerves To Treat Pain

Surgery | January 1, 2024

Balloon Dilation of the Eustachian Tube

Medicine | January 1, 2024

Sphenopalatine Ganglion Block for Headache

Medicine | January 1, 2024

Three-Dimensional Printed Orthopedic Implants

Surgery | January 1, 2024

Absorbable Nasal Implant for Treatment of Nasal Valve Collapse

Surgery | January 1, 2024

Allograft Injection for Degenerative Disc Disease

Medicine | January 1, 2024

Cryoablation, Radiofrequency Ablation and Laser Ablation for Treatment of Chronic Rhinitis

Surgery | January 1, 2024

Laser Interstitial Thermal Therapy for Neurological Conditions

Therapy | January 1, 2024

Injectable Bulking Agents for the Treatment of Urinary and Fecal Incontinence

Surgery | January 1, 2024

Vagus Nerve Stimulation

Surgery | January 1, 2024

Reduction Mammaplasty for Breast-Related Symptoms

Surgery | January 1, 2024

Spinal Cord and Dorsal Root Ganglion Stimulation

Surgery | January 1, 2024

Percutaneous Electrical Nerve Stimulation, Percutaneous Neuromodulation Therapy, and Restorative Neurostimulation

Surgery | January 1, 2024

Implantable Infusion Pump for Pain and Spasticity

Surgery | January 1, 2024

Implantable Cardioverter Defibrillator (ICD)

Surgery | January 1, 2024

Bariatric Surgery

Surgery | January 1, 2024

Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions

Surgery | January 1, 2024

Placental and Umbilical Cord Blood as a Source of Stem Cells

Surgery | January 1, 2024

Transmyocardial Revascularization

Surgery | January 1, 2024

Intraoperative Neurophysiologic Monitoring

Surgery | January 1, 2024

Minimally Invasive Coronary Artery Bypass Graft Surgery

Other | January 1, 2024

Deep Brain Stimulation

Surgery | January 1, 2024

Endovascular Stent Grafts for Abdominal Aortic Aneurysms

Surgery | January 1, 2024

Extracranial Carotid Angioplasty/Stenting

Surgery | January 1, 2024

Sacral Nerve Neuromodulation/Stimulation

Surgery | January 1, 2024

Lung Volume Reduction Surgery for Severe Emphysema

Surgery | January 1, 2024

Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty and Biacuplasty

Surgery | January 1, 2024

Gastric Electrical Stimulation

Surgery | January 1, 2024

Cryosurgical Ablation of Primary or Metastatic Liver Tumors

Surgery | January 1, 2024

Total Ankle Replacement

Surgery | January 1, 2024

Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions

Surgery | January 1, 2024

Whole-Gland Cryoablation of Prostate Cancer

Surgery | January 1, 2024

Hip Resurfacing

Surgery | January 1, 2024

Nerve Graft With Radical Prostatectomy

Surgery | January 1, 2024

Auditory Brainstem Implant

Surgery | January 1, 2024

Semi-Implantable and Fully Implantable Middle Ear Hearing Aids

Surgery | January 1, 2024

Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures

Surgery | January 1, 2024

Endovascular Stent Grafts for Disorders of the Thoracic Aorta

Surgery | January 1, 2024

Radiofrequency Ablation of Primary or Metastatic Liver Tumors

Surgery | January 1, 2024

Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bone

Surgery | January 1, 2024

Decompression of the Intervertebral Disc Using Laser (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty™)

Surgery | January 1, 2024

Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors

Surgery | January 1, 2024

Computer-Assisted Navigation for Orthopedic Procedure

Surgery | January 1, 2024

Minimally Invasive Hip and Knee Arthroplasty

Surgery | January 1, 2024

MR Angiography Spinal Canal

Radiology | January 1, 2024

CT Angiography, Pelvis

Radiology | January 1, 2024

Kidney Transplant

Surgery | January 1, 2024

Allogeneic Pancreas Transplant

Surgery | January 1, 2024

Isolated Small Bowel Transplant

Surgery | January 1, 2024

Small Bowel/Liver and Multivisceral Transplant

Surgery | January 1, 2024

Liver Transplant and Combined Liver-Kidney Transplant

Surgery | January 1, 2024

Lung and Lobar Lung Transplant

Surgery | January 1, 2024

Heart/Lung Transplant

Surgery | January 1, 2024

Heart Transplant

Surgery | January 1, 2024

Total Artificial Hearts and Implantable Ventricular Assist Devices

Surgery | January 1, 2024

Islet Cell Transplantation

Surgery | January 1, 2024

Composite Tissue Allotransplantation of the Hand and Face

Surgery | January 1, 2024

Lower Extremity CTA/CTV

Radiology | January 1, 2024

CT Cervical Spine

Radiology | January 1, 2024

CT Angiography, Abdomen

Radiology | January 1, 2024

CT Thoracic Spine

Radiology | January 1, 2024

CT Angiography, Abdomen and Pelvis

Radiology | January 1, 2024

MRI Lumbar Spine

Radiology | January 1, 2024

MRI Thoracic Spine

Radiology | January 1, 2024

CT Pelvis

Radiology | January 1, 2024

CT Heart

Radiology | January 1, 2024

CT Lumbar Spine

Radiology | January 1, 2024

MRI Pelvis

Radiology | January 1, 2024

CT Lower Extremity (Ankle, Foot, Hip or Knee)

Radiology | January 1, 2024

CT Abdomen and Pelvis

Radiology | January 1, 2024

CT Abdomen

Radiology | January 1, 2024

Upper Extremity MRI (Hand, Wrist, Arm, Elbow, Long Bone or Shoulder MRI)

Radiology | January 1, 2024

MRI Heart

Radiology | January 1, 2024

MRI MRCP MRE MRU Abdomen

Radiology | January 1, 2024

Lower Extremity MRI (Foot, Ankle, Knee, Leg or Hip MRI)

Radiology | January 1, 2024

Radiopharmaceutical Tumor Localization (SPECT), Single Area

Radiology | January 1, 2024

CT (Virtual) Colonoscopy — Diagnostic

Radiology | January 1, 2024

Neck MRA/MRV

Radiology | January 1, 2024

CT Upper Extremity

Radiology | January 1, 2024

CT Angiography, Upper Extremity

Radiology | January 1, 2024

CT Angiography, Head/Brain

Radiology | January 1, 2024

CTA Aortogram with Runoff

Radiology | January 1, 2024

Fetal MRI

Radiology | January 1, 2024

MUGA Scan

Radiology | January 1, 2024

MRI Bone Marrow

Radiology | January 1, 2024

Low-Field MRI

Radiology | January 1, 2024

Orbit, Face, Neck, Sinus MRI

Radiology | January 1, 2024

CT Soft Tissue Neck

Radiology | January 1, 2024

MRI Temporomandiublar Joint (TMJ)

Radiology | January 1, 2024

MRI Cervical Spine

Radiology | January 1, 2024

CT Head/Brain

Radiology | January 1, 2024

MRI Chest (Thorax)

Radiology | January 1, 2024

MRI Brain (Includes Internal Auditory Canal)

Radiology | January 1, 2024

Temporal Bone, Mastoid, Orbits, Sella, Internal Auditory Canal CT

Radiology | January 1, 2024

Sinus Maxillofacial CT

Radiology | January 1, 2024

Myocardial Perfusion Imaging (Nuc Card)

Radiology | January 1, 2024

CT Bone Density Study

Radiology | January 1, 2024

CT Angiography, Chest (Noncoronary)

Radiology | January 1, 2024

CT Chest (Thorax)

Radiology | January 1, 2024

Brain PET Scan

Radiology | January 1, 2024

PELVIS MRA/MRV (Angiography/Venography)

Radiology | January 1, 2024

Abdomen MRA (Angiography)

Radiology | January 1, 2024

Lower Extremity MRA/MRV

Radiology | January 1, 2024

Brain (Head) MRA/MRV

Radiology | January 1, 2024

Hyperthermia With Radiation

Radiology | January 1, 2024

Neutron Beam Therapy (NBT)

Radiology | January 1, 2024

Radiation Therapy for Non-Cancerous Conditions

Radiology | January 1, 2024

PET Scan

Radiology | January 1, 2024

Cerebral Perfusion Analysis CT

Radiology | January 1, 2024

Functional MRI Brain

Radiology | February 1, 2024

MR Angiography Chest

Radiology | January 1, 2024

Heart (Cardiac) PET With CT for Attenuation

Radiology | January 1, 2024

MRI Breast

Radiology | January 1, 2024

CTA Coronary Arteries (CCTA)

Radiology | January 1, 2024

Brain (Head) MRS

Radiology | January 1, 2024

Adoptive Immunotherapy

Medicine | January 1, 2024

Chelation Therapy for Off-Label Uses

Therapy | January 1, 2024

Oncologic Applications of Photodynamic Therapy, Including Barrett Esophagus

Therapy | January 1, 2024

Intraoperative Radiotherapy

Therapy | January 1, 2024

Charged-Particle (Proton or Helium Ion) Radiotherapy for Neoplastic Conditions

Therapy | January 1, 2024

Transcatheter Arterial Chemoembolization To Treat Primary or Metastatic Liver Malignancies

Therapy | January 1, 2024

Brachytherapy for Clinically Localized Prostate Cancer Using Permanently Implanted Seeds

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Therapy | January 1, 2024

Chemical Peels

Therapy | January 1, 2024

Hematopoietic Stem-Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS Syndrome

Therapy | January 1, 2024

Lysis of Epidural Adhesions

Therapy | January 1, 2024

Treatment of Hyperhidrosis

Medicine | January 1, 2024

Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms

Therapy | January 1, 2024

Allogeneic Hematopoietic Stem-Cell Transplantation for Genetic Diseases and Acquired Anemias

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Epithelial Ovarian Cancer

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Miscellaneous Solid Tumors in Adults

Therapy | January 1, 2024

Hematopoietic Stem Cell Transplantation for Autoimmune Diseases

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Breast Cancer

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Central Nervous System Embryonal Tumors and Ependymoma

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Hodgkin Lymphoma

Therapy | January 1, 2024

Autologous Hematopoietic Stem-Cell Transplantation for Malignant Astrocytomas and Gliomas

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Acute Lymphoblastic Leukemia

Therapy | January 1, 2024

High-Dose Rate Temporary Prostate Brachytherapy

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Solid Tumors of Childhood

Therapy | January 1, 2024

Hematopoietic Cell Transplantation in the Treatment of Germ Cell Tumors

Therapy | January 1, 2024

Extracorporeal Photopheresis

Therapy | January 1, 2024

Inhaled Nitric Oxide

Therapy | January 1, 2024

Treatment of Tinnitus

Therapy | January 1, 2024

Manipulation Under Anesthesia

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Primary Amyloidosis

Therapy | January 1, 2024

Radioembolization for Primary and Metastatic Tumors of the Liver

Therapy | January 1, 2024

Intradialytic Parenteral Nutrition

Therapy | January 1, 2024

Intracavitary Balloon Catheter Brain Brachytherapy for Malignant Gliomas or Metastasis to the Brain

Therapy | January 1, 2024

Intensity-Modulated Radiotherapy of the Lung

Therapy | January 1, 2024

Intensity-Modulated Radiotherapy of the Prostate

Therapy | January 1, 2024

Intensity-Modulated Radiotherapy: Cancer of the Head and Neck or Thyroid

Therapy | January 1, 2024

Intensity-Modulated Radiotherapy: Abdomen, Pelvis and Chest

Therapy | January 1, 2024

Orthopedic Applications of Stem Cell Therapy (Including Allografts and Bone Substitutes Used With Autologous Bone Marrow)

Therapy | January 1, 2024

Cellular Immunotherapy for Prostate Cancer

Therapy | January 1, 2024

Hematopoietic Cell Transplantation for Waldenström Macroglobulinemia

Therapy | January 1, 2024

Stem-Cell Therapy for Peripheral Arterial Disease

Therapy | January 1, 2024

Diagnosis and Treatment of Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis

Therapy | January 1, 2024

Baroreflex Stimulation Devices

Therapy | January 1, 2024

Cranial Electrotherapy Stimulation (CES) and Auricular Electrostimulation

Therapy | January 1, 2024

Intensity-Modulated Radiotherapy: Central Nervous System Tumors

Therapy | January 1, 2024

Extracorporeal Membrane Oxygenation for Adult Conditions

Therapy | January 1, 2024

Focal Treatments for Prostate Cancer

Therapy | January 1, 2024

Electronic Brachytherapy for Nonmelanoma Skin Cancer

Therapy | January 1, 2024

Chimeric Antigen Receptor Therapy for Hematologic Malignancies

Prescription Drug | January 1, 2024

Home Non-Invasive Positive Airway Pressure Devices for the Treatment of Respiratory Insufficiency and Failure

Medicine | January 1, 2024

Chimeric Antigen Receptor Therapy for Multiple Myeloma

Prescription Drug | January 1, 2024

Lipid Apheresis

Therapy | January 1, 2024

Functional Neuromuscular Electrical Stimulation, Robotic-Assisted Rehabilitation and Robotic-Assisted Orthotics

Therapy | January 1, 2024

Physical Therapy

Therapy | January 1, 2024

Occupational Therapy

Therapy | January 1, 2024

Speech Therapy

Therapy | January 1, 2024

Outpatient Pulmonary Rehabilitation

Therapy | January 1, 2024

Cardiac Rehabilitation in the Outpatient Setting

Therapy | January 1, 2024

Vertebral Axial Decompression

Therapy | January 1, 2024

Cognitive Rehabilitation

Therapy | January 1, 2024

Endobronchial Brachytherapy

Therapy | January 1, 2024

Sensory Integration Therapy and Auditory Integration Therapy

Therapy | January 1, 2024

Iontophoresis and Phonophoresis

Therapy | January 1, 2024

Evaluation of Hearing Impairment

Other | January 1, 2024

Keratoprosthesis

Other | January 1, 2024

Orthoptic Training for the Treatment of Vision or Learning Disabilities

Other | January 1, 2024

Corneal Topography/Computer-Assisted Corneal Topography/Photokeratoscopy

Other | January 1, 2024

Ophthalmologic Techniques That Evaluate the Posterior Segment for Glaucoma

Other | January 1, 2024

Photodynamic Therapy for Choroidal Neovascularization

Medicine | January 1, 2024

Ocular Photoscreening in the Primary Care Physician's Office as a Screening Tool to Detect Amblyogenic Factors

Other | January 1, 2024

Retinal Telescreening for Diabetic Retinopathy

Other | January 1, 2024

Implantation of Intrastromal Corneal Ring Segments

Other | January 1, 2024

Optical Coherence Tomography of the Anterior Eye Segment

Other | January 1, 2024

Intraocular Radiation Therapy for Age-Related Macular Degeneration

Other | January 1, 2024

Aqueous Shunts and Devices for Glaucoma

Other | January 1, 2024

Endothelial Keratoplasty

Other | January 1, 2024

Intravitreal Corticosteroid Implants

Other | January 1, 2024

Gas-Permeable Scleral Contact Lens

Other | January 1, 2024

Viscocanalostomy and Canaloplasty

Surgery | January 1, 2024

Corneal Collagen Cross-Linking

Other | January 1, 2024

Eyelid Thermal Pulsation for the Treatment of Dry Eye Syndrome

Other | January 1, 2024

Remote Electrical Neuromodulation for Migraines

Medicine | January 1, 2024

Skilled Nursing Facility

Medicine | January 1, 2024

Dry Hydrotherapy for Chronic Pain Condition

Medicine | January 1, 2024

Prenatal Screening (Genetic)

Laboratory | January 1, 2024

Medical Management of Obstructive Sleep Apnea Syndrome

Medicine | January 1, 2024

Genetic Markers for Assessing Risk of Cardiovascular Disease

Laboratory | January 1, 2024

Digital Health Technologies: Diagnostic Applications

Durable Medical Equipment | January 1, 2024

Therapeutic Radiopharmaceuticals for Prostate Cancer

Therapy | January 1, 2024

Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders

Medicine | January 1, 2024

Axillary Reverse Mapping for Breast Cancer-Related Lymphedema

Surgery | January 1, 2024

Annular Closure Devices (e.g., BARRICAID®, XCLOSE®, INCLOSE™)

Durable Medical Equipment | January 1, 2024

Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis

Surgery | January 1, 2024

Temporarily Implanted Nitinol Device (iTind) for Benign Prostatic Hyperplasia

Other | January 1, 2024

Coronary Artery Calcium Scoring by Electron-Beam Tomography (EBCT) OR Non-Contrast Coronary Computed Tomography (Non-Contrast CCT)

Radiology | January 1, 2024

Breast Cancer Radiation Oncology

Radiology | January 1, 2024

Hemgenix® (Etranacogene Dezaparvovec-Drlb)

Prescription Drug | January 1, 2024

Coronavirus Testing in the Outpatient Setting

Laboratory | January 1, 2024

Colorectal Cancer Screening

Laboratory | January 1, 2024

Vascular Endothelial Growth Factor Inhibitors for Sickle Cell Retinopathy

Medicine | January 1, 2024

Percutaneous Arteriovenous Fistula

Medicine | January 1, 2024

Digital Health Technologies: Therapeutic Applications

Mental Health | January 1, 2024

Minimally Invasive Ablation Procedures for Morton and Other Peripheral Neuromas

Therapy | January 1, 2024

Phototherapy: PUVA, UV-B and Targeted Phototherapy

Medicine | January 1, 2024

Orthopedic Implants

Surgery | January 1, 2024

Genomic Testing for Hematopoietic Neoplasms

Laboratory | January 1, 2024

Trigger Point and Tender Point Injections

Medicine | January 1, 2024

Lumbar Artificial Disc Replacement

Surgery | January 1, 2024

Low-Dose CT for Lung Cancer Screening

Radiology | January 1, 2024

Sacroiliac Joint Fusion

Surgery | January 1, 2024

Heart (Cardiac) PET

Radiology | January 1, 2024

Phrenic Nerve Stimulation for Central Sleep Apnea

Therapy | January 1, 2024

Diagnosis of Vaginitis

Laboratory | January 1, 2024

Pediatric Gait Trainers

Durable Medical Equipment | January 1, 2024

Powered Wheeled Mobility Devices

Durable Medical Equipment | January 1, 2024

Wheeled Mobility Devices: Manual Wheelchairs - Standard, Heavy Duty and Lightweight

Durable Medical Equipment | January 1, 2024

Wheeled Mobility Devices: Manual Wheelchairs-Ultra Lightweight

Durable Medical Equipment | January 1, 2024

Wheeled Mobility Devices: Wheelchair Accessories

Durable Medical Equipment | January 1, 2024

Therapeutic Shoes, Inserts or Modifications for Individuals with Diabetes

Durable Medical Equipment | January 1, 2024

Orthopedic Footwear

Durable Medical Equipment | January 1, 2024

Lifting Devices for Use in the Home

Durable Medical Equipment | January 1, 2024

Seat Lift Mechanisms

Durable Medical Equipment | January 1, 2024

Air Conduction Hearing Aids

Durable Medical Equipment | January 1, 2024

Standing Frames

Durable Medical Equipment | January 1, 2024

Private Duty Nursing

Durable Medical Equipment | January 1, 2024

Adjustable Cranial Orthoses

Durable Medical Equipment | January 1, 2024

Roctavian® (valoctocogene roxaparvovec-rvox)

Prescription Drug | January 1, 2024

Vyjuvek (beremagene geperpavec)

Prescription Drug | January 1, 2024

Leqembi™ (lecanemab-irmb)

Prescription Drug | January 1, 2024

Hospital Beds, Bariatric Beds and Accessories

Durable Medical Equipment | January 1, 2024

Orthognathic Surgery

Surgery | January 1, 2024

Enclosed Bed Systems (Safety Enclosure Frame/Canopy) for Hospital Beds

Durable Medical Equipment | April 17, 2024

Mental Health Services

Mental Health | July 1, 2024

Continuous or Intermittent Monitoring of Glucose in Interstitial Fluid

Durable Medical Equipment | July 1, 2024

Enteral Nutrition in the Home

Durable Medical Equipment | July 1, 2024

Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions

Therapy | July 1, 2024

Intraosseous Radiofrequency Ablation (Intracept) Procedure

Surgery | July 1, 2024

Matt Test

Durable Medical Equipment | February 13, 2024

Test Policy One

Durable Medical Equipment | January 31, 2024

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