| Modifier Usage – Professional | C-08010 · Effective Jun 3, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 12 | Original policy ↗ |
| Modifiers 25 and 57: Evaluation and Management with Global Procedures | C-09011 · Effective Nov 23, 2022 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 8 | Original policy ↗ |
| Modifiers 26 and TC: Professional and Technical Component - Professional | C-20004 · Effective Dec 2, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Modifiers 50 and 51: Multiple and Bilateral Surgery - Professional | C-08004 · Effective Oct 30, 2023 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 63 | Original policy ↗ |
| Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service - Professional | C-09006 · Effective Mar 15, 2026 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 187 | Original policy ↗ |
| Modifiers 80, 81, 82 and AS: Assistant at Surgery - Professional | C-08006 · Effective Sep 27, 2023 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 44 | Original policy ↗ |
| Modifiers 90, 91, and 92: Laboratory Services – Professional and Facility | C-26002 · Effective Nov 1, 2026 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 6 | Original policy ↗ |
| Module 1 PDSA Example | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
| Module 2 PDSA Example | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
| Module 3 PDSA Example | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
| Molecular Signature Test for Predicting Response to Tumor Necrosis Factor Inhibitor Therapy | LAB.00042 · Commercial | 1 | Original policy ↗ |
| MRI Guided High Intensity Focused Ultrasound Ablation for Non-Oncologic Indications | MED.00057 · Commercial | 6 | Original policy ↗ |
| Multiple Delivery Services – Professional | C-19005 · Effective Apr 29, 2022 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Multiple Diagnostic Imaging Procedures – Professional and Facility | C-25003 · Effective Oct 26, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Multiple Procedure Payment Reduction – Professional | C-23003 · Effective Apr 12, 2023 · Commercial · CO, CT, GA, IN, KY, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Multiple Surgery – Facility | C-21004 · Effective Jan 1, 2022 · Commercial · CO, CT, GA, IN, KY, MO, NV, OH | — | Original policy ↗ |
| Multiplex Autoantigen Microarray Testing for Systemic Lupus Erythematosus | LAB.00036 · Commercial | 2 | Original policy ↗ |
| Near-Infrared Coronary Imaging and Near-Infrared Intravascular Ultrasound Coronary Imaging | RAD.00057 · Commercial | 1 | Original policy ↗ |
| Non-invasive Cardiac Management and Monitoring Systems | MED.00134 · Commercial | 5 | Original policy ↗ |
| Non-Patient Laboratory Services- Facility | C-21001 · Effective Aug 18, 2025 · Commercial · CO, CT, GA, IN, ME, MO, NV, OH | — | Original policy ↗ |
| Nurse Practitioner and Physician Assistant Services - Professional | C-20001 · Effective Feb 1, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 7 | Original policy ↗ |
| OB/GYN Referral Preparedness Tool (Blank Template) | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
| Observation Services - Facility | C-11005 · Effective Feb 1, 2026 · Commercial · CO, CT, GA, IN, KY, MO, NV, OH, WI | 14 | Original policy ↗ |
| Obstetrical facility consultants | GABCBS-CM-054688-24 · Commercial · GA | — | Original policy ↗ |
| Once-per-Lifetime Procedures – Professional | C-15003 · Effective Aug 13, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Opiod Use Assessment Brochure | Commercial · CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| OptiNet Assessment Tool for Sleep Management FAQs | Commercial · GA | — | Original policy ↗ |
| OptiNet Quick Reference Guide | Commercial · GA | — | Original policy ↗ |
| OptiNet Registration FAQ | Commercial · GA | — | Original policy ↗ |
| Oral, Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or Snoring | SURG.00129 · Commercial | 23 | Original policy ↗ |
| Outpatient Drug Screen Testing- Facility | C-17004 · Effective Jun 8, 2026 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 5 | Original policy ↗ |
| Outpatient Facility Revenue Code Billing Requirements - Facility | C-18003 · Effective May 1, 2026 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Overhead Expenses for Office-Based Surgery and Diagnostic Testing - Professional | C-13002 · Effective Jul 20, 2022 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Pancreas Transplantation and Pancreas Kidney Transplantation | TRANS.00011 · Commercial | 17 | Original policy ↗ |
| Partial Hospitalization Program and Intensive Outpatient Program Services - Facility | C-19002 · Effective Jul 23, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Past medical history and medication linking in the medical record | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Patient-Centered Specialty Care Module 3 Instructional Webinar | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
| Percutaneous Spinal Surgery | SURG.00071 · Commercial | 8 | Original policy ↗ |
| Pharmaceutical Waste – Professional and Facility | C-11031 · Effective Sep 11, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 2 | Original policy ↗ |
| Pharmacy Cost Reduction Strategies | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
| Place of Service - Professional | C-24004 · Effective Dec 10, 2024 · Commercial · CO, CT, GA, IN, KY, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Portable Normothermic Organ Perfusion Systems | TRANS.00039 · Commercial | 10 | Original policy ↗ |
| Powered Robotic Lower Body Exoskeleton Devices | OR-PR.00006 · Commercial | 2 | Original policy ↗ |
| Practice Wisely, Save Time & Improve Outcomes | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
| Practitioner Credentialing Rights | Commercial · CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Preferred Glucometer Program | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
| Pregnancy: Your Birth Options After Cesarean | Commercial · CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Preoperative Testing for Low Risk Invasive Procedures and Surgeries | CG-MED-61 · Commercial | 16 | Original policy ↗ |
| Presentation | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
| Presentation | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
