Payer Policy Changes for Billing Teams

Policy	Payer	Type	Specialty	Date
Thermal Intradiscal Procedures (TIPs) \| CMS Coverage Update	CMS	Modified	Pain Management	May 15, 2026
Heartsbreath Test for Heart Transplant Rejection \| CMS Coverage Update	CMS	Modified	Cardiology	May 15, 2026
Surgery for Diabetes - RETIRED \| CMS Coverage Update	CMS	Modified	Endocrinology	May 15, 2026
Wrong Surgical or Other Invasive Procedure Performed on a Patient \| CMS Coverage Update	CMS	Modified	General Surgery	May 15, 2026
Surgical or Other Invasive Procedure Performed on the Wrong Body Part \| CMS Coverage Update	CMS	Modified	General Surgery	May 15, 2026
Surgical or Other Invasive Procedure Performed on the Wrong Patient \| CMS Coverage Update	CMS	Modified	General Surgery	May 15, 2026
Sleep Testing for Obstructive Sleep Apnea (OSA) \| CMS Coverage Update	CMS	Modified	Pulmonology	May 15, 2026
Positron Emission Tomography (FDG) for Oncologic Conditions \| CMS Coverage Update	CMS	Modified	Oncology	May 15, 2026
Pharmacogenomic Testing for Warfarin Response \| CMS Coverage Update	CMS	Modified	Laboratory	May 15, 2026
Outpatient Intravenous Insulin Treatment \| CMS Coverage Update	CMS	Modified	Endocrinology	May 15, 2026
Screening for the Human Immunodeficiency Virus (HIV) Infection \| CMS Coverage Update	CMS	Modified	Infectious Disease, Primary Care	May 15, 2026
Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer \| CMS Coverage Update	CMS	Modified	Oncology	May 15, 2026
Collagen Meniscus Implant \| CMS Coverage Update	CMS	Modified	Orthopedics & Spine	May 15, 2026
Dermal Injections for the Treatment of Facial Lipodystrophy Syndrome (LDS) \| CMS Coverage Update	CMS	Modified	Dermatology	May 15, 2026
Intensive Cardiac Rehabilitation (ICR) Programs \| CMS Coverage Update	CMS	Modified	Cardiology, Physical Medicine & Rehab	May 15, 2026
The Pritikin Program \| CMS Coverage Update	CMS	Modified	Cardiology	May 15, 2026
Ornish Program for Reversing Heart Disease \| CMS Coverage Update	CMS	Modified	Cardiology	May 15, 2026
Counseling to Prevent Tobacco Use \| CMS Coverage Update	CMS	Modified	Primary Care	May 15, 2026
Home Oxygen Use to Treat Cluster Headache (CH) - RETIRED \| CMS Coverage Update	CMS	Modified	Neurology & Neurosurgery	May 15, 2026
Autologous Cellular Immunotherapy Treatment \| CMS Coverage Update	CMS	Modified	Oncology	May 15, 2026
Transtelephonic Monitoring of Cardiac Pacemakers \| CMS Coverage Update	CMS	Modified	Cardiology	May 15, 2026
Screening for Depression in Adults \| CMS Coverage Update	CMS	Modified	Primary Care	May 15, 2026
Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse \| CMS Coverage Update	CMS	Modified	Primary Care	May 15, 2026
Intensive Behavioral Therapy for Cardiovascular Disease \| CMS Coverage Update	CMS	Modified	Cardiology	May 15, 2026
Ocular Photodynamic Therapy (OPT) \| CMS Coverage Update	CMS	Modified	Ophthalmology	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.