Payer Policy Changes for Billing Teams

Policy	Payer	Type	Specialty	Date
Experimental Procedures and Items, Investigational Devices, and Clinical Trials – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	General / Multi-Specialty	Jun 2, 2026
Gastroesophageal and Gastrointestinal (GI) Services and Procedures – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Gastroenterology	Jun 2, 2026
Gender Dysphoria and Gender Reassignment Surgery – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Behavioral Health	Jun 2, 2026
Hospital, Emergency, and Ambulance Services – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	DME & Home Health	Jun 2, 2026
Medications/Drugs (Outpatient/Part B) – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Pharmacy	Jun 2, 2026
Molecular Pathology/Molecular Diagnostics/Genetic Testing – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Laboratory	Jun 2, 2026
Omnibus Codes – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	General / Multi-Specialty	Jun 2, 2026
Prostate Services and Procedures and Impotence Treatment – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Urology & Nephrology	Jun 2, 2026
Skin Substitutes Grafts/Cellular and Tissue-Based Products (Injections and/or Applications) – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Dermatology	Jun 2, 2026
Lung Cancer Screening with Low Dose Computed Tomography (LDCT) \| CMS Coverage Update	CMS	Modified	Oncology, Radiology & Imaging, Pulmonology, Primary Care	May 30, 2026
Noninvasive Positive Pressure Ventilation (NIPPV) in the Home for the Treatment of Chronic Respiratory Failure (CRF) Consequent to Chronic Obstructive Pulmonary Disease (COPD) \| CMS Coverage Update	CMS	Modified	Pulmonology	May 30, 2026
Cardiac Contractility Modulation (CCM) for Heart Failure (HF) \| CMS Coverage Update	CMS	Modified	Cardiology	May 30, 2026
Donor Lymphocyte Infusion and Hematopoietic Progenitor Cell HPC Boost - (0261) \| CIGNA Coverage Update	CIGNA	Modified	Hematology	May 16, 2026
Hyperbaric and Topical Oxygen Therapies - (0053) \| CIGNA Coverage Update	CIGNA	Modified	General / Multi-Specialty	May 16, 2026
External Counterpulsation - (0058) \| CIGNA Coverage Update	CIGNA	Modified	Cardiology	May 16, 2026
Bone Growth Stimulators: Electrical (Invasive), Ultrasound - (0084) \| CIGNA Coverage Update	CIGNA	Modified	Radiology & Imaging	May 16, 2026
Plantar Fasciitis Treatments - (0097) \| CIGNA Coverage Update	CIGNA	Modified	Podiatry	May 16, 2026
Partial Rhinectomy, Rhinoplasty, Vestibular Stenosis Repair and Septoplasty - (0119) \| CIGNA Coverage Update	CIGNA	Modified	ENT / Otolaryngology	May 16, 2026
Compression Devices - (0354) \| CIGNA Coverage Update	CIGNA	Modified	DME & Home Health	May 16, 2026
Pharmacogenetic Testing - (0500) \| CIGNA Coverage Update	CIGNA	Modified	Laboratory	May 16, 2026
Genetic Testing for Reproductive Carrier Screening and Prenatal Diagnosis - (0514) \| CIGNA Coverage Update	CIGNA	Modified	OB/GYN, Laboratory, Primary Care	May 16, 2026
Molecular and Proteomic Diagnostic Testing for Hematology and Oncology Indications - (0520) \| CIGNA Coverage Update	CIGNA	Modified	Oncology, Hematology	May 16, 2026
Peripheral Nerve Destruction for Pain Conditions - (0525) \| CIGNA Coverage Update	CIGNA	Modified	Pain Management	May 16, 2026
Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) - (0563) \| CIGNA Coverage Update	CIGNA	Modified	Primary Care	May 16, 2026
Cervical Plexus Block - (0579) \| CIGNA Coverage Update	CIGNA	Modified	Orthopedics & Spine	May 16, 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.