Apheresis Commercial - Medical 128
PDF, 291 KBLast Updated: 07/02/2025
Apheresis Medicaid - Medical 128
PDF, 295 KBLast Updated: 07/02/2025
Autologous Myoblast and Muscle Cell Injection Commercial - Medical 262
PDF, 246 KBLast Updated: 05/12/2025
Autologous Myoblast and Muscle Cell Injection Medicaid - Medical 262
PDF, 224 KBLast Updated: 05/12/2025
Automated Nerve Conduction Testing Commercial - Medical 250
PDF, 277 KBLast Updated: 05/12/2025
Automated Nerve Conduction Testing Medicaid - Medical 250
PDF, 298 KBLast Updated: 05/12/2025
Bone Scaffolding Commercial - Medical 02
PDF, 241 KBLast Updated: 01/02/2026
Bone Scaffolding Medicaid - Medical 02
PDF, 290 KBLast Updated: 01/02/2026
Category III codes Commercial - Medical 336
PDF, 450 KBLast Updated: 01/02/2026
Category III codes Medicaid - Medical 336
PDF, 451 KBLast Updated: 01/02/2026
Chemotherapy and Supportive Care Commercial Medical 316
PDF, 305 KBLast Updated: 12/29/2025
Chemotherapy and Supportive Care Medicaid Medical 316
PDF, 308 KBLast Updated: 12/29/2025
Chemotherapy and Supportive Care Medicare - Medical 316
PDF, 325 KBLast Updated: 01/13/2026
Chiropractic Services Commercial - Medical 182
PDF, 381 KBLast Updated: 08/01/2025
Dry Hydrotherapy Commercial - Medical 267
PDF, 218 KBLast Updated: 05/12/2025
Dry Hydrotherapy Medicaid - Medical 267
PDF, 270 KBLast Updated: 05/12/2025
Dry Needling Commercial - Medical 173
PDF, 251 KBLast Updated: 07/02/2025
Dry Needling Medicaid - Medical 173
PDF, 258 KBLast Updated: 07/02/2025
Electric Stimulation Commercial - Medical 349
PDF, 409 KBLast Updated: 02/06/2026
Electric Stimulation Medicaid-Medical 349
PDF, 414 KBLast Updated: 02/06/2026
Enteral and Parenteral Feeding and Intradialytic Parenteral Nutrition Commercial - Medical 13
PDF, 296 KBLast Updated: 05/12/2025
Enteral and Parenteral Feeding and Intradialytic Parenteral Nutrition Medicaid - Medical 13
PDF, 327 KBLast Updated: 05/15/2025
Eustachian tube balloon dilation (ETBD) Tuboplasty Commercial - Medical 328
PDF, 278 KBLast Updated: 05/12/2025
Eustachian tube balloon dilation (ETBD) Tuboplasty Medicaid - Medical 328
PDF, 281 KBLast Updated: 05/12/2025
Eustachian tube balloon dilation (ETBD) Tuboplasty Medicare - Medical 328
PDF, 324 KBLast Updated: 05/15/2025
Fetal Magnetic Cardiac Signal Commercial - Medical 297
PDF, 192 KBLast Updated: 09/02/2025
Fetal Magnetic Cardiac Signal Medicaid -Medical 297
PDF, 215 KBLast Updated: 09/02/2025
Fetal Magnetic Cardiac Signal Medicare - Medical 297
PDF, 217 KBLast Updated: 09/02/2025
Gait analysis and surface electromyography Commercial - Medical 345.pdf
PDF, 207 KBLast Updated: 01/02/2026
Gait Analysis and Surface Electromyography Medicaid - Medical 345.pdf
PDF, 253 KBLast Updated: 01/02/2026
Gait Analysis and Surface Electromyography Medicare - Medical 345.pdf
PDF, 257 KBLast Updated: 01/02/2026
Gastrointestinal Capsule Endoscopy Commercial - Medical 81
PDF, 258 KBLast Updated: 10/23/2025
Gastrointestinal Capsule Endoscopy Medicaid - Medical 81
PDF, 255 KBLast Updated: 10/23/2025
Home Health Aide Commercial - Medical 144
PDF, 228 KBLast Updated: 01/02/2026
Home Health Aide Medicaid - Medical 144
PDF, 231 KBLast Updated: 01/02/2026
Immunoglobulin Light Chains Medicaid - Medical 333
PDF, 234 KBLast Updated: 12/29/2025
Immunoglobulin Light Chains Medicare - Medical 333
PDF, 221 KBLast Updated: 12/29/2025
Implantable Hemodynamic Monitoring for Heart Failure Commercial - Medical 317
PDF, 255 KBLast Updated: 12/01/2025
Implantable Hemodynamic Monitoring for Heart Failure Medicaid - Medical 317
PDF, 277 KBLast Updated: 12/01/2025
Ingestible Devices Commercial - Medical 344
PDF, 196 KBLast Updated: 01/02/2026
Ingestible Devices Medicaid Medical 344.pdf
PDF, 247 KBLast Updated: 01/02/2026
Ingestible Devices Medicare - Medical 344
PDF, 248 KBLast Updated: 01/02/2026
Injectable Fillers & Bulking Agents Commercial - Medical 153
PDF, 244 KBLast Updated: 01/19/2026
Injectable Fillers & Bulking Agents Medicaid - Medical 153
PDF, 268 KBLast Updated: 01/19/2026
Intensive Cardiac Rehabilitation Programs Commercial - Medical 52
PDF, 275 KBLast Updated: 06/04/2025
Intensive Cardiac Rehabilitation Programs Medicaid - Medical 52
PDF, 307 KBLast Updated: 06/04/2025
Intra-arterial (IA) Chemotherapy Commercial - Medical 254
PDF, 316 KBLast Updated: 05/12/2025
Intra-arterial (IA) Chemotherapy Medicaid - Medical 254
PDF, 286 KBLast Updated: 05/12/2025
Keratoconus Lenses and Interventions-Piggyback Contact Lenses Commercial - Medical 03
PDF, 289 KBLast Updated: 06/04/2025
Keratoconus Lenses and Interventions-Piggyback Contact Lenses Medicaid - Medical 03
PDF, 282 KBLast Updated: 12/26/2025
Level of Care Guidance for Observation vs Inpatient Hospital Stays Commercial - Medical 350
PDF, 229 KBLast Updated: 10/27/2025
Level of Care Guidance for Observation vs Inpatient Hospital Stays Medicaid - Medical 350
PDF, 258 KBLast Updated: 10/27/2025
Long-Term Care Hospital (LTACH) Services Medicaid - Medical 337
PDF, 316 KBLast Updated: 07/02/2025
Long-Term Care Hospital (LTACH) Services s Medicare Medical 337.pdf
PDF, 311 KBLast Updated: 12/29/2025
Medical Necessity Guidelines Commercial - Medical 347
PDF, 229 KBLast Updated: 01/02/2026
Mobile Cardiac Telemetry Commercial - Medical 112
PDF, 256 KBLast Updated: 07/02/2025
Mobile Cardiac Telemetry Medicaid - Medical 112
PDF, 280 KBLast Updated: 07/02/2025
Muscle Pain Detector Commercial - Medical 247
PDF, 195 KBLast Updated: 12/29/2025
Muscle Pain Detector Medicaid - Medical 247
PDF, 225 KBLast Updated: 12/29/2025
Nonemergent Ambulance Services Commercial - Medical 105
PDF, 294 KBLast Updated: 08/19/2025
Nonemergent Ambulance Services Medicaid - Medical 105
PDF, 312 KBLast Updated: 06/04/2025
Not Medically Necessary, Experimental, Investigational and Unproven Guidelines Commercial - Medical 348
PDF, 249 KBLast Updated: 01/19/2026
Phase II Cardiac Rehabilitation Commercial - Medical 51
PDF, 304 KBLast Updated: 06/04/2025
Phase II Cardiac Rehabilitation Medicaid - Medical 51
PDF, 279 KBLast Updated: 06/04/2025
Physical Therapy for Treating Obesity Commercial - Medical 252
PDF, 295 KBLast Updated: 05/14/2025
Physical Therapy for Treating Obesity Medicaid - Medical 252
PDF, 297 KBLast Updated: 05/14/2025
Physical Therapy for Treating Obesity Medicare - Medical 252
PDF, 268 KBLast Updated: 05/15/2025
Platelet Rich-Plasma Commercial - Medical 246
PDF, 327 KBLast Updated: 05/12/2025
Platelet Rich-Plasma Medicaid - Medical 246
Sepsis and Other Febrile Illness, Observation Care Medicaid Medical 346 OBS
PDF, 240 KBLast Updated: 01/02/2026
Sepsis and Other Febrile Illness, Observation Care Medical 346 OBS
Sepsis and Other Febrile Illness, without Focal Infection Commercial Medical 346
Sepsis and Other Febrile Illness, without Focal Infection Medicaid Medical 346
PDF, 239 KBLast Updated: 01/02/2026
Transarterial Embolization Direct Therapies (TAE, TACE and DEB-TACE) Commercial - Medical 139
PDF, 319 KBLast Updated: 05/14/2025
Transarterial Embolization Direct Therapies (TAE, TACE and DEB-TACE) Medicaid - Medical 139
PDF, 310 KBLast Updated: 05/12/2025
Transjugular Intrahepatic Portosystemic Shunt (TIPSS) Commercial - Medical 256
PDF, 262 KBLast Updated: 06/04/2025
Transjugular Intrahepatic Portosystemic Shunt (TIPSS) Medicaid - Medical 256
PDF, 298 KBLast Updated: 06/04/2025
Transjugular Intrahepatic Portosystemic Shunt (TIPSS) Medicare - Medical 256
PDF, 294 KBLast Updated: 02/11/2026
Urinary Incontinence Treatments Commercial - Medical 130
PDF, 232 KBLast Updated: 01/02/2026
Urinary Incontinence Treatments Medicaid - Medical 130
PDF, 258 KBLast Updated: 01/02/2026
Vestibular Evoked Myogenic Potential (VEMP) Commercial - Medical 174
PDF, 293 KBLast Updated: 05/12/2025
Vestibular Evoked Myogenic Potential (VEMP) Medicaid - Medical 174
PDF, 294 KBLast Updated: 05/12/2025
Vision Therapy for Convergence Insufficiency Commercial - Medical 324
PDF, 253 KBLast Updated: 08/01/2025
Vision Therapy for Convergence Insufficiency Medicaid - Medical 324
PDF, 284 KBLast Updated: 12/29/2025
Vision Therapy for Convergence Insufficiency Medicare Medical 324
PDF, 302 KBLast Updated: 12/29/2025
Wearable Monitoring and Treatment Devices Commercial Medical 259
PDF, 279 KBLast Updated: 08/01/2025
Wearable Monitoring and Treatment Devices Medicaid Medical 259
PDF, 283 KBLast Updated: 08/01/2025
Wound Treatment Commercial - Medical 343
PDF, 284 KBLast Updated: 09/02/2025
Wound Treatment Medicaid - Medical 343
PDF, 293 KBLast Updated: 09/02/2025