Payer policy changes
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1511 updates
Policy Payer Type Specialty Date
Polymerase Chain Reaction Testing: Selected Indications — CPB 0650 | AETNA Coverage Update AETNA Modified Laboratory Jan 29, 2026
Inotuzumab Ozogamicin (Besponsa) — CPB 0919 | AETNA Coverage Update AETNA Modified Hematology Jan 29, 2026
Dostarlimab-gxly (Jemperli) — CPB 0993 | AETNA Coverage Update AETNA Modified Oncology Jan 29, 2026
Mirvetuximab Soravtansine-gynx (Elahere) — CPB 1021 | AETNA Coverage Update AETNA Modified Oncology Jan 29, 2026
Daprodustat (Jesduvroq) — CPB 1044 | AETNA Coverage Update AETNA Modified Hematology Jan 29, 2026
Prosthetic Limb Vacuum Systems — CPB 0630 | AETNA Coverage Update AETNA Modified Physical Medicine & Rehab Jan 23, 2026
Fam-trastuzumab Deruxtecan-nxki (Enhertu) — CPB 0966 | AETNA Coverage Update AETNA Modified Oncology Jan 23, 2026
Ado-trastuzumab emtansine (Kadcyla) — CPB 0974 | AETNA Coverage Update AETNA Modified Oncology Jan 23, 2026
Allogeneic Processed Thymus Tissue–agdc (Rethymic) — CPB 1055 | AETNA Coverage Update AETNA Modified Hematology Jan 23, 2026
Orthopedic Casts, Braces and Splints — CPB 0009 | AETNA Coverage Update AETNA Modified Orthopedics & Spine Jan 22, 2026
Erythropoesis Stimulating Agents — CPB 0195 | AETNA Coverage Update AETNA Modified Hematology Jan 22, 2026
Trastuzumab (Herceptin and biosimilars), Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta) — CPB 0313 | AETNA Coverage Update AETNA Modified Pharmacy Jan 22, 2026
Hospital Beds and Accessories — CPB 0543 | AETNA Coverage Update AETNA Modified DME & Home Health Jan 22, 2026
Ankle Orthoses, Ankle-Foot Orthoses (AFOs), and Knee-Ankle-Foot Orthoses (KAFOs) — CPB 0565 | AETNA Coverage Update AETNA Modified Orthopedics & Spine, Podiatry Jan 22, 2026
Lumbar Traction Devices — CPB 0569 | AETNA Coverage Update AETNA Modified Orthopedics & Spine Jan 22, 2026
Safety Items — CPB 0623 | AETNA Coverage Update AETNA Modified DME & Home Health Jan 22, 2026
Osseointegration for Lower and Upper Limbs — CPB 1045 | AETNA Coverage Update AETNA Modified Orthopedics & Spine Jan 22, 2026
Autologous Chondrocyte Implantation — CPB 0247 | AETNA Coverage Update AETNA Modified Orthopedics & Spine Jan 18, 2026
Allograft Transplants of the Extremities — CPB 0364 | AETNA Coverage Update AETNA Modified Orthopedics & Spine Jan 18, 2026
Foot Orthotics — CPB 0451 | AETNA Coverage Update AETNA Modified Physical Medicine & Rehab, Podiatry Jan 18, 2026
Pillows and Cushions — CPB 0456 | AETNA Coverage Update AETNA Modified DME & Home Health Jan 18, 2026
Seat Lifts and Patient Lifts — CPB 0459 | AETNA Coverage Update AETNA Modified DME & Home Health Jan 18, 2026
Compression Garments for the Legs — CPB 0482 | AETNA Coverage Update AETNA Modified DME & Home Health Jan 18, 2026
Osteochondral Autografts (Mosaicplasty, OATS) — CPB 0637 | AETNA Coverage Update AETNA Modified Orthopedics & Spine Jan 18, 2026
Nutritional Support — CPB 0061 | AETNA Coverage Update AETNA Modified Gastroenterology Jan 17, 2026

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