Payer Policy Changes for Billing Teams

Policy	Payer	Type	Specialty	Date
Prostate Cancer Screening Tests \| CMS Coverage Update	CMS	Modified	Oncology, Urology & Nephrology, Primary Care	May 15, 2026
Home Prothrombin Time/International Normalized Ratio (PT/INR) Monitoring for Anticoagulation Management \| CMS Coverage Update	CMS	Modified	Hematology	May 15, 2026
Outpatient Hospital Services for Treatment of Alcoholism \| CMS Coverage Update	CMS	Modified	Behavioral Health	May 15, 2026
Sensory Nerve Conduction Threshold Tests (sNCTs) \| CMS Coverage Update	CMS	Modified	Neurology & Neurosurgery	May 15, 2026
Single Photon Emission Computed Tomography (SPECT) \| CMS Coverage Update	CMS	Modified	Radiology & Imaging	May 15, 2026
Percutaneous Image-Guided Breast Biopsy \| CMS Coverage Update	CMS	Modified	Oncology	May 15, 2026
Transcutaneous Electrical Nerve Stimulators (TENS) - RETIRED \| CMS Coverage Update	CMS	Modified	DME & Home Health	May 15, 2026
Speech Generating Devices \| CMS Coverage Update	CMS	Modified	DME & Home Health	May 15, 2026
Multiple Electroconvulsive Therapy (MECT) \| CMS Coverage Update	CMS	Modified	Behavioral Health	May 15, 2026
Deep Brain Stimulation for Essential Tremor and Parkinson’s Disease \| CMS Coverage Update	CMS	Modified	Neurology & Neurosurgery	May 15, 2026
Treatment of Drug Abuse (Chemical Dependency) \| CMS Coverage Update	CMS	Modified	Pharmacy	May 15, 2026
Intestinal and Multi-Visceral Transplantation \| CMS Coverage Update	CMS	Modified	Gastroenterology	May 15, 2026
Colorectal Cancer Screening Tests \| CMS Coverage Update	CMS	Modified	Oncology, Primary Care	May 15, 2026
Acupuncture for Fibromyalgia \| CMS Coverage Update	CMS	Modified	Rheumatology	May 15, 2026
Acupuncture for Osteoarthritis \| CMS Coverage Update	CMS	Modified	Rheumatology	May 15, 2026
Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee \| CMS Coverage Update	CMS	Modified	Orthopedics & Spine	May 15, 2026
Islet Cell Transplantation in the Context of a Clinical Trial \| CMS Coverage Update	CMS	Modified	Endocrinology	May 15, 2026
FDG PET for Dementia and Neurodegenerative Diseases \| CMS Coverage Update	CMS	Modified	Neurology & Neurosurgery	May 15, 2026
Treatment of Alcoholism and Drug Abuse in a Freestanding Clinic \| CMS Coverage Update	CMS	Modified	Pharmacy	May 15, 2026
PET for Perfusion of the Heart \| CMS Coverage Update	CMS	Modified	Cardiology	May 15, 2026
FDG PET for Esophageal Cancer (Replaced with Section 220.6.17) - RETIRED \| CMS Coverage Update	CMS	Modified	Oncology	May 15, 2026
FDG PET for Refractory Seizures \| CMS Coverage Update	CMS	Modified	Neurology & Neurosurgery	May 15, 2026
FDG PET for Brain, Cervical, Ovarian, Pancreatic, Small Cell Lung, and Testicular Cancers (Replaced with Section 220.6.17) - RETIRED \| CMS Coverage Update	CMS	Modified	Oncology, Orthopedics & Spine, Neurology & Neurosurgery, Gastroenterology, Pulmonology	May 15, 2026
FDG PET for All Other Cancer Indications Not Previously Specified (Replaced with Section 220.6.17) - RETIRED \| CMS Coverage Update	CMS	Modified	Oncology	May 15, 2026
FDG PET for Breast Cancer (Replaced with Section 220.6.17) - RETIRED \| CMS Coverage Update	CMS	Modified	Oncology	May 15, 2026

Payer policy changesfor billing and compliance teams.

One missed policy change can cost thousands in denied claims.

Payer policy changes
for billing and compliance teams.