Observation Payment Policy Update

Policy Update #: POLOBSPAY06302026
Effective Date: June 30, 2026
Current State: Medicaid & Commercial policy guidance was combined under Policy #3836. Medicare specific policy guidance was maintained under Policy #4546
Future State: Medicaid & Commercial Plans Payment Policy #3836 has undergone annual review and update. Medicare Payment Policy #4546 will be retired.
Applicable Plan(s): Medicaid, Commercial and Medicare
Applicable Policy: Medicaid and Commercial Policy #3836. Medicare Policy #4546
Business Owner: Cost of Care

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Observation Payment Policy Update