Payer Policy Changes for Billing Teams

Policy	Payer	Type	Specialty	Date
Aural Rehabilitation \| AETNA Coverage Update	AETNA	Modified	Physical Medicine & Rehab	Mar 12, 2026
Allergy and Hypersensitivity \| AETNA Coverage Update	AETNA	Modified	General / Multi-Specialty	Mar 12, 2026
Weight Reduction Programs and Devices — CPB 0039 \| AETNA Coverage Update	AETNA	Modified	Endocrinology	Mar 12, 2026
Prenatal Care Provided by Primary Care Physicians — CPB 0047 \| AETNA Coverage Update	AETNA	Modified	OB/GYN, Primary Care	Mar 12, 2026
Hepatitis A Vaccine — CPB 0048 \| AETNA Coverage Update	AETNA	Modified	Gastroenterology, Infectious Disease	Mar 12, 2026
Nutritional Counseling — CPB 0049 \| AETNA Coverage Update	AETNA	Modified	Endocrinology	Mar 12, 2026
Stereotactic Radiosurgery — CPB 0083 \| AETNA Coverage Update	AETNA	Modified	Radiology & Imaging	Mar 12, 2026
Parenteral Immunoglobulins — CPB 0206 \| AETNA Coverage Update	AETNA	Modified	DME & Home Health	Mar 12, 2026
Ziconotide (Prialt) — CPB 0712 \| AETNA Coverage Update	AETNA	Modified	Pain Management	Mar 12, 2026
Antiemetic Therapy — CPB 0724 \| AETNA Coverage Update	AETNA	Modified	Oncology	Mar 12, 2026
Electromagnetic Navigation-guided Bronchoscopy — CPB 0776 \| AETNA Coverage Update	AETNA	Modified	Pulmonology	Mar 12, 2026
Obinutuzumab (Gazyva) — CPB 0877 \| AETNA Coverage Update	AETNA	Modified	Oncology	Mar 12, 2026
Ustekinumab — CPB 0912 \| AETNA Coverage Update	AETNA	Modified	Rheumatology	Mar 12, 2026
Durvalumab (Imfinzi) — CPB 0917 \| AETNA Coverage Update	AETNA	Modified	Oncology	Mar 12, 2026
Lutetium Lu Dotatate (Lutathera) and Lutetium Lu 177 Vipivotide Tetraxetan (Pluvicto) — CPB 0929 \| AETNA Coverage Update	AETNA	Modified	Oncology	Mar 12, 2026
Cemiplimab (Libtayo) — CPB 0942 \| AETNA Coverage Update	AETNA	Modified	Oncology	Mar 12, 2026
Onasemnogene abeparvovec-xioi (Zolgensma) — CPB 0953 \| AETNA Coverage Update	AETNA	Modified	Neurology & Neurosurgery	Mar 12, 2026
Inebilizumab-cdon (Uplizna) — CPB 0975 \| AETNA Coverage Update	AETNA	Modified	Neurology & Neurosurgery	Mar 12, 2026
Lurbinectedin (Zepzelca) — CPB 0978 \| AETNA Coverage Update	AETNA	Modified	Oncology	Mar 12, 2026
Lisocabtagene Maraleucel (Breyanzi) — CPB 0986 \| AETNA Coverage Update	AETNA	Modified	Oncology	Mar 12, 2026
Routine Costs in Clinical Trials — NCD 1 \| CMS Coverage Update	CMS	Modified	General / Multi-Specialty	Mar 12, 2026
Glycated Hemoglobin/Glycated Protein — NCD 100 \| CMS Coverage Update	CMS	Modified	Endocrinology	Mar 12, 2026
Thyroid Testing — NCD 101 \| CMS Coverage Update	CMS	Modified	Endocrinology	Mar 12, 2026
Lipid Testing — NCD 102 \| CMS Coverage Update	CMS	Modified	Laboratory	Mar 12, 2026
Digoxin Therapeutic Drug Assay — NCD 103 \| CMS Coverage Update	CMS	Modified	Pharmacy	Mar 12, 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.