Fecha de vigencia | Policy Name | Reviewed Date |
8/24/2023 |
Ablation Techniques and Extracorporeal Shock Wave Therapy for Musculoskeletal Indications and Soft Tissue Wounds
| 8/24/2023 |
1/1/2024 |
Ablation Techniques and Extracorporeal Shock Wave Therapy for Musculoskeletal Indications and Soft Tissue Wounds - Medicare Advantage
| 11/16/2023 |
5/25/2023 |
Tratamientos para acalasia y enfermedad de reflujo gastroesofágico (ERGE)
| 5/25/2023 |
1/1/2024 |
Achalasia and Gastroesophageal Reflux Disease Treatments - Medicare Advantage
| 10/10/2023 |
3/13/2023 |
Acne Treatments
| 2/2/2023 |
9/28/2023 |
Actinic Keratoses Treatments
| 9/28/2023 |
12/8/2022 |
Acupuntura
| 12/8/2022 |
4/27/2023 |
Ambulancia aérea
| 4/27/2023 |
3/1/2023 |
Airway Clearance Devices
| 3/1/2023 |
1/1/2024 |
Airway Clearance Devices - Medicare Advantage
| 11/16/2023 |
3/1/2023 |
Pruebas para la alergia
| 3/1/2023 |
9/22/2022 |
Tratamientos para la alergia
| 9/22/2022 |
2/2/2023 |
Allograft Transplantation of the Knee
| 2/2/2023 |
1/1/2024 |
Allograft Transplantation of the Knee - Medicare Advantage
| 11/16/2023 |
6/22/2023 |
Dispositivos de monitoreo cardiaco ambulatorio
| 3/23/2023 |
1/1/2024 |
Ambulatory Cardiac Monitoring Devices - Medicare Advantage
| 10/10/2023 |
3/1/2023 |
Applied Behavior Analysis
| 3/1/2023 |
3/23/2023 |
Reemplazo artificial de disco intervertebral
| 3/23/2023 |
1/1/2024 |
Artificial Intervertebral Disc Replacement - Medicare Advantage
| 11/16/2023 |
3/23/2023 |
Athletic Pubalgia Surgery
| 3/23/2023 |
1/1/2024 |
Athletic Pubalgia Surgery - Medicare Advantage
| 11/16/2023 |
6/22/2023 |
Trastorno por déficit de atención con hiperactividad (ADHD) - Diagnóstico y tratamiento
| 6/22/2023 |
1/1/2021 |
Auryxia (ferric citrate)
| 3/15/2023 |
3/1/2023 |
Autism Spectrum Disorders Diagnosis and Treatment
| 3/1/2023 |
1/1/2024 |
Autism Spectrum Disorders Diagnosis and Treatments - Medicare Advantage
| 11/16/2023 |
5/25/2023 |
Autologous and Allogeneic Bone Marrow Transplants
| 5/25/2023 |
1/1/2024 |
Autologous and Allogeneic Bone Marrow Transplants/Peripheral Stem Cell Transplants/Umbilical Cord Blood Transplants - Medicare Advantage
| 11/16/2023 |
2/2/2023 |
Autonomic Nerve Function Testing
| 2/2/2023 |
4/27/2023 |
Balloon Dilation (Eustachian Tube and Sinus), Functional Endoscopic Sinus Surgery and RhinAer
| 4/27/2023 |
1/1/2024 |
Balloon Dilation (Eustachian Tube and Sinus), Functional Endoscopic Sinus Surgery and RhinAer - Medicare Advantage
| 10/10/2023 |
7/1/2023 |
Cirugía bariátrica
| 3/1/2023 |
1/1/2024 |
Bariatric Surgery - Medicare Advantage
| 10/10/2023 |
3/1/2023 |
Benign Prostatic Hyperplasia Treatments
| 3/1/2023 |
1/1/2024 |
Benign Prostatic Hyperplasia Treatments - Medicare Advantage
| 10/24/2023 |
12/8/2022 |
Bioretroalimentación
| 12/8/2022 |
4/27/2023 |
Blepharoplasty, Blepharoptosis Repair, and Brow Lift
| 4/27/2023 |
1/1/2024 |
Blepharoplasty, Blepharoptosis Repair, and Brow Lift - Medicare Advantage
| 11/14/2023 |
5/25/2023 |
Medición de densidad ósea
| 5/25/2023 |
3/1/2023 |
Sustitutos de injerto óseo
| 3/1/2023 |
1/1/2024 |
Bone Graft Substitutes - Medicare Advantage
| 11/14/2023 |
2/27/2023 |
Estimuladores para el crecimiento de los huesos
| 2/2/2023 |
5/25/2023 |
Braquiterapia
| 5/25/2023 |
1/1/2024 |
Brachytherapy - Medicare Advantage
| 10/24/2023 |
10/1/2023 |
Breast Imaging
| 8/24/2023 |
1/1/2024 |
Breast Imaging - Medicare Advantage
| 11/16/2023 |
5/25/2023 |
Reconstrucción de mama
| 5/25/2023 |
1/1/2024 |
Breast Reconstruction - Medicare Advantage
| 11/14/2023 |
7/27/2023 |
Bronchial Thermoplasty
| 7/27/2023 |
1/1/2024 |
Bronchial Thermoplasty - Medicare Advantage
| 10/10/2023 |
5/25/2023 |
Tratamientos quirúrgicos para juanetes y juanetes de sastre
| 5/25/2023 |
1/1/2024 |
Bunion and Bunionette Surgical Treatments - Medicare Advantage
| 11/16/2023 |
1/1/2021 |
Calcitonin gene_related peptide (CGRP) inhibitors
| 5/18/2023 |
9/1/2022 |
Calcitonin gene_related peptide (CGRP) inhibitors
| 5/18/2023 |
8/24/2023 |
Endoscopía capsular
| 8/24/2023 |
1/1/2024 |
Capsule Endoscopy - Medicare Advantage
| 10/10/2023 |
3/1/2023 |
Cateterización cardíaca
| 3/1/2023 |
1/1/2024 |
Cardiac Catheterization - Medicare Advantage
| 10/10/2023 |
5/25/2023 |
Estudios electrofisiológicos cardíacos y ablación cardíaca por catéter
| 4/27/2023 |
1/1/2024 |
Cardiac Electrophysiological Studies and Cardiac Catheter Ablation - Medicare Advantage
| 11/16/2023 |
1/1/2024 |
Cardiac Pacemakers - Medicare Advantage
| 11/21/2023 |
11/2/2023 |
Rehabilitación cardíaca
| 11/2/2023 |
10/3/2023 |
Cardiac Single Photon Emission Computed Tomography
| 8/24/2023 |
1/1/2024 |
Cardiac Single-Photon Emission Computed Tomography - Medicare Advantage
| 10/10/2023 |
11/2/2023 |
Cardiovascular Disease Risk Testing

| 11/2/2023 |
7/27/2023 |
Desfibriladores cardioversores/terapia de resincronización cardíaca
| 3/1/2023 |
1/1/2024 |
Cardioverter Defibrillators/Cardiac Resynchronization Therapy - Medicare Advantage
| 10/10/2023 |
11/2/2023 |
Revascularización de la arteria carótida

| 11/2/2023 |
1/1/2024 |
Carotid Revascularization - Medicare Advantage
| 11/16/2023 |
9/28/2023 |
Carpal Tunnel Syndrome Surgical Treatments
| 9/28/2023 |
1/1/2024 |
Carpal Tunnel Syndrome Surgical Treatments - Medicare Advantage
| 10/3/2023 |
7/27/2023 |
Atención quiropráctica
| 7/27/2023 |
8/24/2023 |
Chronic Vertigo Evaluation and Treatment
| 8/24/2023 |
9/28/2023 |
Ensayos clínicos
| 9/28/2023 |
6/22/2023 |
Code Compendium (Cardiovascular)
| 6/22/2023 |
6/22/2023 |
Compendio de códigos (laboratorio)
| 4/27/2023 |
11/2/2023 |
Compendio del código (misceláneo)

| 11/2/2023 |
6/22/2023 |
Compendio de códigos (musculosqueléticos y neurológicos)
| 6/22/2023 |
1/1/2024 |
Code Compendium (Musculoskeletal and Neurologic) - Medicare Advantage
| 10/10/2023 |
2/2/2023 |
Code Compendium (Obstetrics -Gynecology)
| 2/2/2023 |
10/1/2023 |
Compendio del código (oftalmología)
| 6/22/2023 |
9/28/2023 |
Code Compendium (Wound Care)
| 9/28/2023 |
1/1/2024 |
Code Compendium (Wound Care) - Medicare Advantage
| 10/24/2023 |
4/27/2023 |
Rehabilitación congnitiva
| 4/27/2023 |
1/1/2024 |
Cold and Heat Therapy Devices - Medicare Advantage
| 11/16/2023 |
9/28/2023 |
Cold Therapy Devices/ Heating Devices/ Combined Heat and Cold Therapy Devices
| 9/28/2023 |
12/8/2022 |
Colorectal Cancer Screening and Surveillance
| 12/8/2022 |
1/1/2024 |
Colorectal Cancer Screening and Surveillance - Medicare Advantage
| 11/16/2023 |
9/28/2023 |
Comparative Genomic Hybridization/Chromosomal Microarray
| 9/28/2023 |
8/24/2023 |
Medicina complementaria y alternativa
| 8/24/2023 |
1/1/2024 |
Complementary and Alternative Medicine - Medicare Advantage
| 11/16/2023 |
1/1/2024 |
Comprehensive Genomic Profiling and Genetic Testing for Solid Tumors - Medicare Advantage
| 10/23/2023 |
9/28/2023 |
Comprehensive Molecular Profiling for Hematologic Malignancies and Solid Tumors
| 6/22/2023 |
8/24/2023 |
Concurrent DNA and RNA Genetic Testing
| 8/24/2023 |
8/24/2023 |
Control ambulatorio continuo de presión arterial
| 8/24/2023 |
7/1/2023 |
Continuous Glucose Monitoring Systems and Insulin Pumps
| 4/27/2023 |
2/2/2023 |
Continuous Passive Motion and Mechanical Stretching Devices
| 2/2/2023 |
2/2/2023 |
Coronary CT Angiography, Fractional Flow Reserve with CT, Calcium Scoring
| 2/2/2023 |
1/1/2024 |
Coronary CT Angiography, Fractional Flow Reserve with CT, Calcium Scoring - Medicare Advantage
| 11/16/2023 |
5/25/2023 |
Coronary Stents and Angioplasty
| 5/25/2023 |
10/10/2023 |
Cosmetic and Reconstructive Surgery
| 8/24/2023 |
1/1/2024 |
Cosmetic and Reconstructive Surgery - Medicare Advantage
| 11/14/2023 |
1/1/2024 |
Cranial Electrical Stimulation - Medicare Advantage
| 11/16/2023 |
12/8/2022 |
Cryoablation
| 12/8/2022 |
1/1/2024 |
Cryoablation - Medicare Advantage
| 11/14/2023 |
7/27/2023 |
Deep Brain Stimulation and Cortical Brain Stimulation
| 7/27/2023 |
1/1/2024 |
Deep Brain Stimulation and Cortical Stimulation - Medicare Advantage
| 11/21/2023 |
10/3/2023 |
Diagnostic Esophagogastroduodenoscopy or Esophagascopy (age 59 years or younger)
| 4/27/2023 |
1/1/2024 |
Diagnostic Esophagogastroduodenoscopy or Esophagoscopy - Medicare Advantage
| 10/10/2023 |
1/1/2024 |
Diagnostic Imaging - Medicare Advantage
| 11/28/2023 |
6/22/2023 |
Digital Therapeutics
| 3/1/2023 |
3/1/2023 |
Discograma
| 3/1/2023 |
9/28/2023 |
Análisis
| 9/28/2023 |
1/1/2024 |
Drug Testing - Medicare Advantage
| 11/14/2023 |
10/3/2023 |
Equipo médico duradero
| 2/2/2023 |
6/22/2023 |
Dynamic Spinal Stabilization Devices
| 6/22/2023 |
1/1/2024 |
Dynamic Spinal Stabilization Devices - Medicare Advantage
| 11/16/2023 |
11/2/2023 |
Cirugía electiva de reparación de aneurisma de aorta y arteria ilíaca

| 11/2/2023 |
1/1/2024 |
Elective Aorta and Iliac Artery Aneurysm Repair - Medicare Advantage
| 11/16/2023 |
2/2/2023 |
Campos eléctricos para el tratamiento de tumores
| 2/2/2023 |
1/1/2024 |
Electric Tumor Treatment Fields - Medicare Advantage
| 11/16/2023 |
3/23/2023 |
Electrical Stimulation and Electromagnetic Therapy for the Treatment of Wounds
| 3/23/2023 |
7/27/2023 |
Estimuladores eléctricos - Nervio frénico/del diafragma, funcionales y neuromusculares
| 7/27/2023 |
1/1/2024 |
Electrical Stimulators - Diaphragmatic/Phrenic Nerve, Functional and Neuromuscular - Medicare Advantage
| 11/16/2023 |
4/27/2023 |
Electrical Stimulators for Pain and Nausea/Vomiting
| 4/27/2023 |
12/8/2022 |
Electrothermal Intradiscal Therapies
| 12/8/2022 |
1/1/2024 |
Electrothermal Intradiscal Therapies - Medicare Advantage
| 11/16/2023 |
9/28/2023 |
Emerging Tumor Markers for Diagnosis and Monitoring of Cancer
| 2/2/2023 |
8/24/2023 |
Endobronchial Valves for Emphysema
| 8/24/2023 |
1/1/2024 |
Endobronchial Valves for Emphysema - Medicare Advantage
| 11/16/2023 |
3/1/2023 |
Erectile Dysfunction and Peyronie's Disease Treatments
| 3/1/2023 |
1/1/2024 |
Erectile Dysfunction and Peyronie's Disease Treatments - Medicare Advantage
| 11/16/2023 |
1/1/2024 |
Excision and Mastectomy for Breast Lesions - Medicare Advantage
| 11/28/2023 |
6/22/2023 |
Exhaled Breath Tests
| 6/22/2023 |
12/8/2022 |
Oftalmoscopía extendida
| 12/8/2022 |
3/1/2023 |
Extraosseous Subtalar Joint implantation and Subtalar Arthroereisis
| 3/1/2023 |
1/1/2024 |
Extraosseous Subtalar Joint Implantation and Subtalar Arthroereisis - Medicare Advantage
| 11/16/2023 |
1/1/2024 |
Facility Based Sleep Studies - Medicare Advantage
| 11/28/2023 |
12/8/2022 |
Fecal Incontinence Evaluation and Treatments
| 12/8/2022 |
1/1/2024 |
Fecal Incontinence Evaluation and Treatments - Medicare Advantage
| 10/24/2023 |
9/1/2023 |
Fecal Microbiota Transplantation
| 7/27/2023 |
6/22/2023 |
Fusion Imaging for Cancer Indications
| 6/22/2023 |
1/1/2024 |
Fusion Imaging for Cancer Indications - Medicare Advantage
| 11/16/2023 |
7/27/2023 |
Fusion Imaging for Noncancer Indications
| 7/27/2023 |
1/1/2024 |
Fusion Imaging for Noncancer Indications - Medicare Advantage
| 11/16/2023 |
3/23/2023 |
Gastric Pacing/Gastric Electrical Stimulation
| 3/23/2023 |
1/1/2024 |
Gastric Pacing/Gastric Electrical Stimulation - Medicare Advantage
| 10/10/2023 |
7/1/2023 |
Gastrointestinal Motility Monitoring
| 3/23/2023 |
9/28/2023 |
Gender Affirmation Surgery
| 9/28/2023 |
1/1/2024 |
Gender Affirmation Surgery - Medicare Advantage
| 11/21/2023 |
4/27/2023 |
Gene Expression Profiling for Cancer Indications
| 4/27/2023 |
1/1/2024 |
Gene Expression Profiling for Cancer Indications - Medicare Advantage
| 11/14/2023 |
4/27/2023 |
Gene Expression Profiling for Noncancer Indications
| 4/27/2023 |
1/1/2024 |
Gene Expression Profiling for Noncancer Indications - Medicare Advantage
| 11/16/2023 |
9/8/2023 |
Gene Expression Profiling for Prostate Cancer
| 8/24/2023 |
8/24/2023 |
Prueba genética o de marcador biológico para la enfermedad de Alzheimer
| 8/24/2023 |
1/1/2024 |
Genetic and Biomarker Testing for Alzheimer Disease - Medicare Advantage
| 11/14/2023 |
7/27/2023 |
Genetic and Coagulation Testing for Noncancer Blood Disorders
| 7/27/2023 |
1/1/2024 |
Genetic and Coagulation Testing for Noncancer Blood Disorders - Medicare Advantage
| 11/16/2023 |
3/1/2023 |
Exámenes genéticos
| 3/1/2023 |
1/1/2024 |
Genetic Testing - Medicare Advantage
| 10/24/2023 |
11/2/2023 |
Genetic Testing and Liquid Biopsy for Prostate Cancer

| 11/2/2023 |
4/27/2023 |
Genetic Testing for Angelman and Prader-Willi Syndrome
| 4/27/2023 |
3/23/2023 |
Prueba genética de susceptibilidad al cáncer de mama, ovario y páncreas
| 3/23/2023 |
2/2/2023 |
Prueba genética de susceptibilidad al cáncer
| 2/2/2023 |
8/24/2023 |
Prueba genética para afecciones cardíacas
| 8/24/2023 |
1/1/2024 |
Genetic Testing for Cardiac Conditions - Medicare Advantage
| 11/14/2023 |
7/1/2023 |
Pruebas genéticas para detección de portadores
| 12/8/2022 |
2/2/2023 |
Genetic Testing for Celiac Disease
| 2/2/2023 |
4/27/2023 |
Genetic Testing for Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy Syndrome
| 4/27/2023 |
2/2/2023 |
Prueba genética de susceptibilidad al cáncer de colon
| 2/2/2023 |
8/24/2023 |
Prueba genética para fibrosis quística
| 8/24/2023 |
5/25/2023 |
Prueba genética para el diagnóstico y monitoreo del cáncer
| 5/25/2023 |
1/1/2024 |
Genetic Testing for Diagnosis of Inherited Conditions - Medicare Advantage
| 11/16/2023 |
9/28/2023 |
Prueba genética para el diagnóstico de indicaciones no cancerígenas
| 9/28/2023 |
9/28/2023 |
Prueba genética para riesgo de enfermedades
| 9/28/2023 |
3/23/2023 |
Genetic Testing for Ehlers-Danlos Syndrome
| 3/23/2023 |
1/1/2024 |
Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders - Medicare Advantage
| 11/14/2023 |
6/22/2023 |
Pruebas genéticas para detectar ataxia hereditaria
| 6/23/2022 |
1/1/2024 |
Genetic Testing for Hereditary Ataxias - Medicare Advantage
| 11/14/2023 |
1/1/2024 |
Genetic Testing for Hereditary Breast, Ovarian, Pancreatic and Prostate Cancer - Medicare Advantage
| 11/14/2023 |
1/1/2024 |
Genetic Testing for Hereditary Cancer - Medicare Advantage
| 10/24/2023 |
1/1/2024 |
Genetic Testing for Hereditary Colorectal and Uterine Cancer - Medicare Advantage
| 11/14/2023 |
6/22/2023 |
Genetic Testing for Hereditary Peripheral Neuropathies
| 6/22/2023 |
3/1/2023 |
Genetic Testing for Marfan Syndrome and Related Conditions
| 3/1/2023 |
3/23/2023 |
Genetic Testing for Methylene Tetrahydrofolate Reductase
| 3/23/2023 |
5/25/2023 |
Pruebas genéticas para detectar distrofia muscular y atrofia muscular espinal
| 5/25/2023 |
12/8/2022 |
Genetic Testing for Niemann-Pick Disease
| 12/8/2022 |
9/28/2023 |
Genetic Testing for RASopathy Syndromes
| 9/28/2023 |
4/27/2023 |
Glaucoma Surgical Treatments
| 4/27/2023 |
1/1/2024 |
Glaucoma Surgical Treatments - Medicare Advantage
| 10/10/2023 |
3/23/2023 |
Gynecomastia Surgery
| 3/23/2023 |
2/2/2023 |
Hammer Toe Surgical Treatments
| 2/2/2023 |
1/1/2024 |
Hammertoe Surgical Treatments - Medicare Advantage
| 11/16/2023 |
3/23/2023 |
Tratamientos para la migraña y la neuralgia occipital
| 3/23/2023 |
1/1/2024 |
Headache and Occipital Neuralgia Treatments - Medicare Advantage
| 11/14/2023 |
11/2/2023 |
Artroplastia de cadera

| 11/2/2023 |
1/1/2024 |
Hip Arthroplasty - Medicare Advantage
| 10/24/2023 |
12/8/2022 |
Hip, Knee and Shoulder Arthroscopic Surgeries
| 12/8/2022 |
1/1/2024 |
Hip, Knee and Shoulder Arthroscopic Surgeries - Medicare Advantage
| 11/16/2023 |
4/27/2023 |
Home Births and Birth Doulas
| 4/27/2023 |
6/22/2023 |
Atención en el hogar
| 6/22/2023 |
5/25/2023 |
Monitoreo de oximetría en el hogar
| 5/25/2023 |
1/1/2024 |
Hospital Services (Long Term Care Hospitals (LTCH), Observation) - Medicare Advantage
| 11/14/2023 |
5/25/2023 |
Hyperbaric Oxygen Therapy, Topical Oxygen Therapy
| 5/25/2023 |
1/1/2024 |
Hyperbaric Oxygen Therapy, Topical Oxygen Therapy - Medicare Advantage
| 11/14/2023 |
4/27/2023 |
Hyperhidrosis Treatments
| 4/27/2023 |
1/1/2024 |
Hyperthermia for Treatment of Cancer - Medicare Advantage
| 11/16/2023 |
11/2/2023 |
Hyperthermia Treatment for Cancer (Local, Regional and Whole Body)
| 11/2/2023 |
10/27/2022 |
Immunoassay Testing for Rupture of Membranes in Pregnancy
| 10/27/2022 |
2/2/2023 |
Implantable and Non-Implantable Hearing Devices
| 2/2/2023 |
1/1/2024 |
Implantable and Non-Implantable Hearing Devices - Medicare Advantage
| 11/16/2023 |
1/1/2024 |
Implantable Cardiac Devices for Hemodynamic Management - Medicare Advantage
| 10/10/2023 |
5/25/2023 |
Bombas de infusión implantables para pacientes con dolor o espasmos
| 5/25/2023 |
1/1/2024 |
Implantable Infusion Pumps for Pain or Spasticity - Medicare Advantage
| 11/16/2023 |
3/23/2023 |
In Vitro Chemoresistance and Chemosensitivity Assays
| 3/23/2023 |
4/27/2023 |
Infertility Evaluation and Treatment
| 4/27/2023 |
1/1/2024 |
Infertility Evaluation and Treatments - Medicare Advantage
| 11/16/2023 |
11/2/2023 |
Inhaled Nitric Oxide
| 11/2/2023 |
7/27/2023 |
Inyecciones para afecciones con dolor crónico
| 7/27/2023 |
1/1/2024 |
Injections for Chronic Pain Conditions - Medicare Advantage
| 11/21/2023 |
1/1/2024 |
Inpatient Hospital Services - Medicare Advantage
| 10/24/2023 |
10/10/2023 |
Intensity Modulated Radiation Therapy
| 7/27/2023 |
1/1/2024 |
Intensity Modulated Radiation Therapy - Medicare Advantage
| 11/21/2023 |
8/24/2023 |
Interspinous Process Decompression Spacers
| 8/24/2023 |
1/1/2024 |
Interspinous Process Decompression Spacers - Medicare Advantage
| 11/14/2023 |
7/27/2023 |
Intraocular Lens Implants
| 7/27/2023 |
6/22/2023 |
Intraoperative Neurological Monitoring
| 6/22/2023 |
1/1/2024 |
Intraoperative Neurological Monitoring - Medicare Advantage
| 10/10/2023 |
4/27/2023 |
Irreversible Electroporation (NanoKnife)
| 4/27/2023 |
7/27/2023 |
Janus Kinase 2 (JAK2) V617F, Exon 12 -15, Calreticulin (CALR) and MPL Mutation Analysis
| 7/27/2023 |
5/25/2023 |
Tratamientos quirúrgicos del queratocono
| 5/25/2023 |
10/9/2023 |
Artroplastia de rodilla
| 7/27/2023 |
1/1/2024 |
Knee Arthroplasty - Medicare Advantage
| 10/24/2023 |
7/27/2023 |
Laboratorio de análisis para cáncer de próstata
| 7/27/2023 |
6/22/2023 |
Laparoscopic Hiatal Hernia Repair
| 6/22/2023 |
1/1/2024 |
Laparoscopic Hiatal Hernia Repair - Medicare Advantage
| 11/16/2023 |
3/1/2023 |
Terapia térmica intersticial con láser
| 3/1/2023 |
5/25/2023 |
Leadless Cardiac Pacemakers
| 5/25/2023 |
9/28/2023 |
Cierre del apéndice auricular izquierdo y defectos estructurales cardíacos para prevenir accidentes cerebrovasculares
| 9/28/2023 |
1/1/2024 |
Left Atrial Appendage and Cardiac Structural Defect Closure for Stroke Prevention - Medicare Advantage
| 11/21/2023 |
9/28/2023 |
Biopsia líquida
| 2/2/2023 |
1/1/2024 |
Liquid Biopsy - Medicare Advantage
| 11/16/2023 |
5/25/2023 |
Low Level Laser and High Power Laser Therapy
| 5/25/2023 |
1/1/2024 |
Low Level Laser Therapy and High Power Laser Therapy - Medicare Advantage
| 10/24/2023 |
1/1/2024 |
Lung Biopsy and Resection - Medicare Advantage
| 11/28/2023 |
9/28/2023 |
Prueba de detección del cáncer de pulmón
| 9/28/2023 |
1/1/2024 |
Lymphedema - Diagnosis and Treatment - Medicare Advantage
| 10/24/2023 |
5/25/2023 |
Lymphedema (Diagnosis and Treatment)
| 5/25/2023 |
7/27/2023 |
Manipulation Under Anesthesia
| 7/27/2023 |
1/1/2024 |
Measurable (Minimal) Residual Disease Testing - Medicare Advantage
| 11/14/2023 |
9/28/2023 |
Microwave Thermotherapy
| 9/28/2023 |
1/1/2024 |
Microwave Thermotherapy - Medicare Advantage
| 11/16/2023 |
6/22/2023 |
Mobility Assistive Devices (Wheelchairs)
| 6/22/2023 |
1/1/2024 |
Molecular Biomarkers for Prostate Cancer Risk Stratification - Medicare Advantage
| 11/14/2023 |
3/1/2023 |
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection
| 3/1/2023 |
1/1/2024 |
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - Medicare Advantage
| 11/14/2023 |
3/23/2023 |
Molecular Diagnostic Testing for Lyme Disease and other Vector Borne Illness
| 3/23/2023 |
7/27/2023 |
Pruebas moleculares de diagnóstico de salud reproductiva
| 7/27/2023 |
3/1/2023 |
Marcadores moleculares en biopsias con agujas finas de nódulos en la tiroides
| 3/1/2023 |
1/1/2024 |
Molecular Markers in Fine Needle Aspirates of Thyroid Nodules - Medicare Advantage
| 10/24/2023 |
7/27/2023 |
Molecular Testing for HLA B27 for Ankylosing Spondylitis
| 7/27/2023 |
1/1/2024 |
Molecular Testing for HLA-B*27 for Ankylosing Spondylitis - Medicare Advantage
| 11/14/2023 |
9/28/2023 |
Multianalyte Assays with Algorithmic Analyses for Cancer Indications
| 5/25/2023 |
1/1/2024 |
Multianalyte Assays with Algorithmic Analyses for Cancer Indications - Medicare Advantage
| 11/16/2023 |
10/1/2023 |
Multianalyte Assays with Algorithmic Analyses for Noncancer Indications
| 6/22/2023 |
1/1/2024 |
Multiplex Pathogen Identification Panels for Infectious Disease - Medicare Advantage
| 11/16/2023 |
10/1/2023 |
Multiplex Pathogen Testing and Next Generation Sequencing for Infectious Disease
| 12/8/2022 |
3/23/2023 |
Terapia de presión negativa para heridas
| 3/23/2023 |
1/1/2024 |
Negative Pressure Wound Therapy - Medicare Advantage
| 11/14/2023 |
3/23/2023 |
Nerve Conduction Testing, Somatosensory and Visual Evoked Potentials, Surface Electromyography
| 3/23/2023 |
11/2/2023 |
Técnicas neuroablativas para el dolor crónico

| 11/2/2023 |
1/1/2024 |
Neuroablative Techniques for Chronic Pain - Medicare Advantage
| 11/28/2023 |
9/28/2023 |
Respiradores no invasivos para el hogar
| 9/28/2023 |
1/1/2024 |
Noninvasive Home Ventilators - Medicare Advantage
| 11/14/2023 |
7/27/2023 |
Noninvasive Prenatal Testing
| 7/27/2023 |
9/28/2023 |
Pruebas no invasivas para fibrosis hepática
| 2/2/2023 |
1/1/2024 |
Noninvasive Tests for Hepatic Fibrosis - Medicare Advantage
| 11/16/2023 |
1/1/2016 |
Antihistamínicos no sedantes
| 3/15/2023 |
5/25/2023 |
Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Nonsurgical Treatments
| 5/25/2023 |
1/1/2024 |
Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Nonsurgical Treatments - Medicare Advantage
| 11/16/2023 |
6/22/2023 |
Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments
| 6/22/2023 |
1/1/2024 |
Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments - Medicare Advantage
| 10/24/2023 |
12/8/2022 |
Ocular Surface Disease Diagnosis and Treatments
| 12/8/2022 |
1/1/2024 |
Ocular Surface Disease Diagnosis and Treatments - Medicare Advantage
| 11/16/2023 |
6/22/2023 |
Omisirge (omidubicel-onlv)
| 6/22/2023 |
1/1/2024 |
Omisirge (omidubicel-onlv) - Medicare Advantage
| 11/16/2023 |
3/1/2023 |
Cirugía ortognática
| 3/1/2023 |
1/1/2024 |
Orthognathic Surgery - Medicare Advantage
| 11/16/2023 |
10/1/2023 |
Ortopedia
| 3/1/2023 |
1/1/2024 |
Orthotics - Medicare Advantage
| 11/21/2023 |
12/8/2022 |
Cirugía de defectos osteocondrales y subcondrales
| 12/8/2022 |
1/1/2024 |
Osteochondral and Subchondral Defects Surgery - Medicare Advantage
| 11/16/2023 |
1/1/2024 |
Outpatient Rehabilitation (Physical Therapy, Occupational Therapy) - Medicare Advantage
| 11/21/2023 |
11/2/2023 |
Panniculectomy, Abdominoplasty, Abdominal Contouring

| 11/2/2023 |
1/1/2024 |
Percutaneous Coronary Intervention - Medicare Advantage
| 10/10/2023 |
1/1/2024 |
Percutaneous Vertebroplasty, Kyphoplasty (Balloon-Assisted Vertebroplasty), Sacroplasty - Medicare Advantage
| 11/14/2023 |
1/1/2023 |
Percutaneous Vertebroplasty, Kyphoplasty, Sacroplasty
| 9/22/2022 |
2/2/2023 |
Peripheral Artery Disease of the Lower Extremities Angiography, Screening and Exercise Rehabilitation
| 2/2/2023 |
2/2/2023 |
Peripheral Artery Revascularization of the Lower Extremities
| 2/2/2023 |
1/1/2024 |
Peripheral Artery Revascularization of the Lower Extremities - Medicare Advantage
| 11/14/2023 |
1/1/2024 |
Peripheral Nerve Stimulators - Medicare Advantage
| 11/14/2023 |
1/1/2024 |
Pharmacogenomic Testing - Medicare Advantage
| 11/14/2023 |
11/2/2023 |
Farmacogenómica - Citocromo P450, polimorfismos y VKORC1

| 11/2/2023 |
4/27/2023 |
Pharmacogenomics - Noncancer Indications
| 4/27/2023 |
8/24/2023 |
Farmacogenómica y diagnóstico complementario
| 8/24/2023 |
1/1/2024 |
Pharmacogenomics and Companion Diagnostics - Medicare Advantage
| 11/14/2023 |
9/12/2023 |
Physical Therapy (PT) and Occupational Therapy (OT)
| 6/22/2023 |
7/27/2023 |
Tratamientos para fascitis plantar
| 7/27/2023 |
8/24/2023 |
Factor de crecimiento derivado de plaquetas para la cicatrización
| 8/24/2023 |
1/1/2024 |
Platelet Derived Growth Factors for Wound Healing - Medicare Advantage
| 10/24/2023 |
4/27/2023 |
Pneumatic Compression Pumps
| 4/27/2023 |
11/2/2023 |
Preimplantation Genetic Testing
| 11/2/2023 |
2/2/2023 |
Prueba genética para el diagnóstico prenatal invasivo
| 2/2/2023 |
2/2/2023 |
Mastectomía profiláctica
| 2/2/2023 |
2/2/2023 |
Prostatectomía
| 2/2/2023 |
1/1/2024 |
Prostatectomy - Medicare Advantage
| 11/28/2023 |
11/2/2023 |
Prótesis

| 11/2/2023 |
1/1/2024 |
Prosthetics - Medicare Advantage
| 11/14/2023 |
6/22/2023 |
Proton Beam, Neutron Beam and Carbon Ion Radiation Therapy
| 6/22/2023 |
1/1/2024 |
Proton Beam, Neutron Beam and Carbon Ion Radiation Therapy - Medicare Advantage
| 11/16/2023 |
1/1/2024 |
Psychiatric Inpatient Hospitalization - Medicare Advantage
| 11/14/2023 |
1/1/2024 |
Psychiatric Partial Hospital Program Services - Medicare Advantage
| 11/14/2023 |
9/28/2023 |
Rehabilitación pulmonar
| 9/28/2023 |
9/28/2023 |
Radiofrequency Tumor Ablation
| 9/28/2023 |
1/1/2024 |
Radiofrequency Tumor Ablation - Medicare Advantage
| 10/24/2023 |
3/23/2023 |
Pérdida de embarazo recurrente
| 3/23/2023 |
7/27/2023 |
Cirugía de reducción de mamas
| 7/27/2023 |
1/1/2024 |
Reduction Mammaplasty - Medicare Advantage
| 11/14/2023 |
1/1/2020 |
Rexulti (brexpiprazole)
| 5/17/2023 |
7/27/2023 |
Artritis reumatoide: marcadores biológicos y evaluación farmacológica
| 7/27/2023 |
1/1/2024 |
Rheumatoid Arthritis: Biologic Markers and Pharmacologic Assessment - Medicare Advantage
| 11/14/2023 |
5/25/2023 |
Rhinoplasty-Septoplasty
| 5/25/2023 |
9/28/2023 |
Scanning Computerized Ophthalmic Diagnostic Imaging
| 9/28/2023 |
1/1/2024 |
Serological and Fecal Testing for Inflammatory Bowel Disease - Medicare Advantage
| 11/14/2023 |
6/22/2023 |
Pruebas serológicas y fecales para la detección de enfermedad intestinal inflamatoria (IBD)
| 6/22/2023 |
5/25/2023 |
Severe Acute Respiratory Syndrome Coronavirus 2 Serologic (Antibody) Testing
| 5/25/2023 |
8/24/2023 |
Severe Acute Respiratory Syndrome Coronavirus 2 Viral Testing
| 8/24/2023 |
8/24/2023 |
Artroplastia de hombro
| 8/24/2023 |
1/1/2024 |
Shoulder Arthroplasty - Medicare Advantage
| 11/16/2023 |
11/2/2023 |
Sustitutos de piel y tejido

| 2/2/2023 |
1/1/2024 |
Skin and Tissue Substitutes - Medicare Advantage
| 11/14/2023 |
12/8/2022 |
Skin Lesion Surveillance Technologies
| 12/8/2022 |
12/8/2022 |
Skysona (elivaldogene autotemcel)
| 12/8/2022 |
1/1/2024 |
Skysona (elivaldogene autotemcel) - Medicare Advantage
| 11/16/2023 |
2/2/2023 |
Sleep Studies, Adults
| 2/2/2023 |
4/27/2023 |
Solid Organ Transplants
| 4/27/2023 |
1/1/2024 |
Solid Organ Transplants - Medicare Advantage
| 11/16/2023 |
9/28/2023 |
Speech Generating Devices, Voice Prostheses
| 9/28/2023 |
12/8/2022 |
Terapia del habla
| 12/8/2022 |
8/24/2023 |
Estimuladores de la médula espinal
| 8/24/2023 |
1/1/2024 |
Spinal Cord Stimulators - Medicare Advantage
| 11/21/2023 |
9/28/2023 |
Cirugía de descompresión espinal
| 9/28/2023 |
1/1/2024 |
Spinal Decompression Surgery - Medicare Advantage
| 11/16/2023 |
10/2/2023 |
Cirugía de fusión espinal
| 12/8/2022 |
1/1/2024 |
Spinal Fusion Surgery - Medicare Advantage
| 11/16/2023 |
8/24/2023 |
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy
| 8/24/2023 |
1/1/2024 |
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy - Medicare Advantage
| 11/28/2023 |
1/1/2024 |
Substance Use Disorder Inpatient Services - Medicare Advantage
| 11/14/2023 |
1/1/2024 |
Substance Use Disorder Partial Hospital Program Services - Medicare Advantage
| 11/14/2023 |
3/23/2023 |
Support Garments, Fabric
| 3/23/2023 |
1/1/2024 |
Temporomandibular Disorders - Medicare Advantage
| 11/14/2023 |
9/28/2023 |
Temporomandibular Joint Disorders
| 9/28/2023 |
1/1/2024 |
Thyroid Surgeries (Thyroidectomy & Lobectomy) - Medicare Advantage
| 10/10/2023 |
11/2/2023 |
Thyroid Surgeries (Thyroidectomy and Lobectomy)
| 11/2/2023 |
6/22/2023 |
Tilt Table Testing
| 6/22/2023 |
4/27/2023 |
Tinnitus Treatments
| 4/27/2023 |
1/1/2024 |
Tinnitus Treatments - Medicare Advantage
| 11/16/2023 |
9/28/2023 |
Tissue Doppler Imaging (Tissue Doppler Echocardiography, Tissue Doppler
| 9/28/2023 |
3/23/2023 |
Transcatheter Intravascular Stents
| 3/23/2023 |
1/1/2024 |
Transcatheter Peripheral Vascular Stents - Chest, Abdomen and Pelvis - Medicare Advantage
| 10/10/2023 |
4/27/2023 |
Procedimientos de válvula transcatéter
| 4/27/2023 |
1/1/2024 |
Transcatheter Valve Procedures - Medicare Advantage
| 10/10/2023 |
4/27/2023 |
Transcranial Magnetic Stimulation and Cranial Electrical Stimulation
| 3/23/2023 |
1/1/2024 |
Transesophageal and Transthoracic Echocardiogram - Medicare Advantage
| 11/21/2023 |
1/1/2024 |
Ultraviolet Light/Laser Therapy for Skin Conditions - Medicare Advantage
| 11/16/2023 |
8/24/2023 |
Ultraviolet Light-Laser Therapy for Skin Conditions
| 8/24/2023 |
4/1/2023 |
Urinary Bladder Dysfunction
| 12/8/2022 |
1/1/2024 |
Urinary Bladder Dysfunction - Medicare Advantage
| 11/14/2023 |
6/22/2023 |
Tratamientos quirúrgicos para fibromas uterinos
| 6/22/2023 |
1/1/2024 |
Uterine Fibroid Surgical Treatments - Medicare Advantage
| 11/16/2023 |
8/24/2023 |
Vagus Nerve Stimulation
| 8/24/2023 |
1/1/2024 |
Vagus Nerve Stimulation - Medicare Advantage
| 11/16/2023 |
3/23/2023 |
Varicose Vein Treatments
| 3/23/2023 |
1/1/2024 |
Varicose Vein Treatments - Medicare Advantage
| 11/14/2023 |
3/23/2023 |
Ventricular Assist Device Total Artificial Heart
| 3/23/2023 |
1/1/2024 |
Ventricular Assist Device, Total Artificial Heart - Medicare Advantage
| 11/14/2023 |
9/28/2023 |
Videofluoroscopy, Dynamic MRI for Musculoskeletal Indications
| 9/28/2023 |
1/1/2024 |
Videofluoroscopy, Dynamic MRI for Musculoskeletal Indications - Medicare Advantage
| 11/16/2023 |
7/27/2023 |
Prueba de vitamina D
| 7/27/2023 |
10/1/2023 |
Whole Genome/Exome Sequencing and Genome-Wide Association Studies
| 3/23/2023 |
10/1/2023 |
Whole Mitochondrial Genome Sequencing and Multigene Panels for Mitochondrial Disorders
| 3/1/2023 |
4/27/2023 |
Zynteglo (betibeglogene autotemcel)
| 12/8/2022 |
1/1/2024 |
Zynteglo (betibeglogene autotemcel) - Medicare Advantage
| 11/16/2023 |