| Elivaldogene autotemcel | RX501.149 · Effective Jan 1, 2026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Emergency Department Services Evaluation and Management (E/M) Coding – Professional Services | CPCP042 · Effective Nov 14, 2025 · Commercial, Medicaid · IL | 5 | Original policy ↗ |
| Emergency Department Services Evaluation and Management - E/M Coding – Facility Services | CPCP003 · Effective Oct 6, 2025 · Commercial, Medicaid · IL | 14 | Original policy ↗ |
| Endoscopic Radiofrequency Ablation or Cryoablation for Barrett Esophagus | SUR709.033 · Effective Jan 1, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| Endoscopic Ultrasound-Guided Direct Hepatic Portosystemic Pressure Gradient Measurement | SUR701.043 · Commercial, Medicaid | 1 | Original policy ↗ |
| Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms) | SUR701.027 · Effective Dec 1, 2025 · Commercial, Medicaid | 16 | Original policy ↗ |
| Endovascular Stent Grafts for Disorders of the Thoracic Aorta | MED202.057 · Effective May 1, 2026 · Commercial, Medicaid | 12 | Original policy ↗ |
| Enzyme-Replacement Therapy for Lysosomal Storage Disorders | RX501.067 · Commercial, Medicaid | 20 | Original policy ↗ |
| Epithelial Cell Cytology in Breast Cancer Risk Assessment | RPLAB024 · Effective Sep 4, 2026 · Commercial, Medicaid · IL | 5 | Original policy ↗ |
| Eptinezumab-jjmr | RX501.124 · Effective Apr 1, 2026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Erythropoiesis-Stimulating Agents (ESAs) | RX501.069 · Effective Jan 1, 2026 · Commercial, Medicaid | 9 | Original policy ↗ |
| Esketamine Nasal Spray | RX501.105 · Commercial, Medicaid | 5 | Original policy ↗ |
| Esophageal pH Monitoring | MED201.005 · Commercial, Medicaid | 5 | Original policy ↗ |
| Etranacogene dezaparvovec-drlb | RX501.151 · Effective Jan 1, 2026 · Commercial, Medicaid | 4 | Original policy ↗ |
| Etuvetidigene autotemcel | RX501.191 · Commercial, Medicaid | 1 | Original policy ↗ |
| Evaluation and Management Coding – Professional Provider Services | CPCP024 · Effective Feb 23, 2026 · Commercial, Medicaid · IL | 42 | Original policy ↗ |
| Evaluation of Dry Eyes | RPLAB043 · Effective Sep 4, 2026 · Commercial, Medicaid · IL | 4 | Original policy ↗ |
| Evinacumab-dgnb | RX501.136 · Commercial, Medicaid | 1 | Original policy ↗ |
| External Counterpulsation (ECP) Therapy for Severe Angina | MED202.050 · Effective May 15, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Extracorporeal Photopheresis | THE801.026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions | SUR705.018 · Effective Nov 1, 2025 · Commercial, Medicaid | 6 | Original policy ↗ |
| Extracranial Carotid Angioplasty or Stenting | SUR701.028 · Commercial, Medicaid | 5 | Original policy ↗ |
| Eyelid Thermal Pulsation for the Treatment of Dry Eye Syndrome | OTH903.025 · Effective Jul 1, 2026 · Commercial, Medicaid | 4 | Original policy ↗ |
| Facet Arthroplasty | SUR712.034 · Commercial, Medicaid | 2 | Original policy ↗ |
| Facet Joint and Sacroiliac Joint Denervation | SUR702.017 · Commercial, Medicaid | 6 | Original policy ↗ |
| Facet Joint Injections | SUR702.015 · Commercial, Medicaid | 13 | Original policy ↗ |
| Faricimab-svoa | OTH903.044 · Commercial, Medicaid | 2 | Original policy ↗ |
| FDA - Drugs, Biologicals, Cellular and Gene Therapies | RX501.087 · Commercial, Medicaid | 6 | Original policy ↗ |
| Fecal Analysis in the Diagnosis of Intestinal Dysbiosis | MED207.118 · Effective May 15, 2026 · Commercial, Medicaid | — | Original policy ↗ |
| Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing | CPCPLAB025 · Effective Jan 1, 2026 · Commercial, Medicaid · IL | 20 | Original policy ↗ |
| Fecal Microbiota Transplantation (FMT) | SUR703.049 · Commercial, Medicaid | 4 | Original policy ↗ |
| Fetal Surgery for Prenatally Diagnosed Malformations | SUR701.016 · Commercial, Medicaid | 13 | Original policy ↗ |
| Flow Cytometry | RPLAB001 · Effective Sep 4, 2026 · Commercial, Medicaid · IL | 13 | Original policy ↗ |
| Focal Treatments for Prostate Cancer | SUR717.004 · Commercial, Medicaid | 6 | Original policy ↗ |
| Folate Testing | RPLAB048 · Effective Sep 4, 2026 · Commercial, Medicaid · IL | 3 | Original policy ↗ |
| Functional Neuromuscular Electrical Stimulation | MED201.033 · Effective Aug 1, 2025 · Commercial, Medicaid | 7 | Original policy ↗ |
| Gamma-glutamyl Transferase in Adults | CPCPLAB056 · Effective Jan 1, 2026 · Commercial, Medicaid · IL | 1 | Original policy ↗ |
| Gamma-glutamyl Transferase in Adults | RPLAB056 · Effective Dec 4, 2026 · Commercial, Medicaid · IL | 1 | Original policy ↗ |
| Gastrointestinal Pathogen Panels | MED207.155 · Commercial, Medicaid | 5 | Original policy ↗ |
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | SUR717.001 · Commercial, Medicaid | 127 | Original policy ↗ |
| Gene Therapies for Metachromatic Leukodystrophy | RX501.171 · Effective Dec 15, 2025 · Commercial, Medicaid | 1 | Original policy ↗ |
| Gene Therapies for Sickle Cell Disease | RX501.167 · Effective Sep 15, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Gene Therapies for Thalassemia | RX501.166 · Effective Sep 1, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Gene Therapies for Treatment of Wounds in Dystrophic Epidermolysis Bullosa | RX501.164 · Effective Jun 15, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Gene Therapy for Aromatic L-amino Acid Decarboxylase Deficiency | RX501.178 · Effective Nov 15, 2025 · Commercial, Medicaid | 3 | Original policy ↗ |
| Gene Therapy for Inherited Retinal Dystrophy | RX501.098 · Effective Aug 1, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| General Inflammation Testing | CPCPLAB049 · Effective Jan 1, 2026 · Commercial, Medicaid · IL | 4 | Original policy ↗ |
| General Inflammation Testing | RPLAB049 · Effective Dec 4, 2026 · Commercial, Medicaid · IL | 4 | Original policy ↗ |
| Genicular Artery Embolization | SUR705.048 · Effective Jul 15, 2025 · Commercial, Medicaid | 5 | Original policy ↗ |
| Givosiran for Acute Hepatic Porphyria | RX501.125 · Effective Nov 1, 2025 · Commercial, Medicaid | 1 | Original policy ↗ |