Payer Policy Changes for Billing Teams

Policy	Payer	Type	Specialty	Date
Intraocular Photography — NCD 56 \| CMS Coverage Update	CMS	Modified	Ophthalmology	Jan 9, 2026
Bariatric Surgery for Treatment of Co-Morbid Conditions Related to Morbid Obesity — NCD 57 \| CMS Coverage Update	CMS	Modified	Gastroenterology	Jan 9, 2026
Diathermy Treatment — NCD 58 \| CMS Coverage Update	CMS	Modified	Pain Management	Jan 9, 2026
Withdrawal Treatments for Narcotic Addictions — NCD 59 \| CMS Coverage Update	CMS	Modified	Behavioral Health	Jan 9, 2026
Cellular Therapy — NCD 6 \| CMS Coverage Update	CMS	Modified	Oncology	Jan 9, 2026
Use of Visual Tests Prior to and General Anesthesia during Cataract Surgery — NCD 60 \| CMS Coverage Update	CMS	Modified	Ophthalmology	Jan 9, 2026
Blood Counts — NCD 61 \| CMS Coverage Update	CMS	Modified	Laboratory	Jan 9, 2026
Cardiac Catheterization Performed in Other than a Hospital Setting - RETIRED — NCD 62 \| CMS Coverage Update	CMS	Modified	Cardiology	Jan 9, 2026
Assessing Patient's Suitability for Electrical Nerve Stimulation Therapy — NCD 63 \| CMS Coverage Update	CMS	Modified	Pain Management	Jan 9, 2026
Breast Reconstruction Following Mastectomy — NCD 64 \| CMS Coverage Update	CMS	Modified	Oncology	Jan 9, 2026
Osteogenic Stimulators — NCD 65 \| CMS Coverage Update	CMS	Modified	Orthopedics & Spine	Jan 9, 2026
Hyperthermia for Treatment of Cancer — NCD 66 \| CMS Coverage Update	CMS	Modified	Oncology	Jan 9, 2026
Cochleostomy with Neurovascular Transplant for Meniere's Disease — NCD 67 \| CMS Coverage Update	CMS	Modified	ENT / Otolaryngology	Jan 9, 2026
Hemodialysis for Treatment of Schizophrenia — NCD 68 \| CMS Coverage Update	CMS	Modified	Urology & Nephrology	Jan 9, 2026
Laser Procedures — NCD 69 \| CMS Coverage Update	CMS	Modified	General Surgery	Jan 9, 2026
Thermogenic Therapy — NCD 7 \| CMS Coverage Update	CMS	Modified	Pain Management	Jan 9, 2026
Adult Liver Transplantation — NCD 70 \| CMS Coverage Update	CMS	Modified	Gastroenterology	Jan 9, 2026
Pediatric Liver Transplantation — NCD 71 \| CMS Coverage Update	CMS	Modified	Gastroenterology	Jan 9, 2026
Carotid Body Resection/Carotid Body Denervation — NCD 8 \| CMS Coverage Update	CMS	Modified	ENT / Otolaryngology	Jan 9, 2026
Phaco-Emulsification Procedure - Cataract Extraction — NCD 9 \| CMS Coverage Update	CMS	Modified	Ophthalmology	Jan 9, 2026
Bezlotoxumab (Zinplava) — CPB 0914 \| AETNA Coverage Update	AETNA	Modified	Infectious Disease	Jan 8, 2026
Home Health Aides — CPB 0218 \| AETNA Coverage Update	AETNA	Modified	DME & Home Health	Jan 5, 2026
Occupational Therapy Services — CPB 0250 \| AETNA Coverage Update	AETNA	Modified	Physical Medicine & Rehab	Jan 5, 2026
Plasmapheresis/Plasma Exchange/Therapeutic Apheresis — CPB 0285 \| AETNA Coverage Update	AETNA	Modified	Hematology	Jan 5, 2026
Etanercept — CPB 0315 \| AETNA Coverage Update	AETNA	Modified	Rheumatology	Jan 5, 2026

Policy updates for healthcarebilling and compliance teams.

One missed policy change can cost thousands in denied claims.

Policy updates for healthcare
billing and compliance teams.