Horizon Blue Cross and Blue Shield of New Jersey policies

Search Horizon Blue Cross and Blue Shield of New Jersey's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

834 public policies Substrate tracks for Horizon Blue Cross and Blue Shield of New Jersey, by title.

Horizon Blue Cross and Blue Shield of New Jersey policies
PolicyDetailsCodesSource
[Claim Editing] Hospital Non-Patient Laboratory Services Sample FeesHospital Non-Patient Laboratory Services Sample FeesCommercial—Original policy ↗
Abatacept (Orencia)Commercial—Original policy ↗
Abdominoplasty, Panniculectomy and Diastasis Muscle Repair025 · Commercial, Medicaid—Original policy ↗
Ablation of Peripheral Nerves to Treat PainCommercial, Medicaid—Original policy ↗
Ablation Procedures for Peripheral NeuromasCommercial—Original policy ↗
Absorbable Nasal Implant for Treatment of Nasal Valve CollapseCommercial—Original policy ↗
ActigraphyCommercial, Medicaid—Original policy ↗
AcupunctureCommercial, Medicaid—Original policy ↗
Acute Hospital Care at HomeEffective Dec 2, 2024 · Commercial, Medicaid—Original policy ↗
Adipose-Derived Stem Cells in Autologous Fat Grafting to the BreastCommercial, Medicaid—Original policy ↗
Adjustable Cranial Orthoses for Positional Plagiocephaly and CraniosynostosesCommercial, Medicaid1Original policy ↗
Adoptive ImmunotherapyCommercial, Medicaid—Original policy ↗
Adult Abdomen Imaging PolicyCommercial, Medicaid16Original policy ↗
Adult Breast ImagingCommercial, Medicaid20Original policy ↗
Adult Cardiac Imaging PolicyCommercial, Medicaid5Original policy ↗
Adult Chest Imaging PolicyCommercial, Medicaid15Original policy ↗
Adult Head Imaging PolicyCommercial, Medicaid26Original policy ↗
Adult Musculoskeletal Imaging PolicyCommercial, Medicaid42Original policy ↗
Adult Neck Imaging PolicyCommercial, Medicaid13Original policy ↗
Adult Oncology Imaging PolicyCommercial, Medicaid32Original policy ↗
Adult Pelvis Imaging PolicyCommercial, Medicaid13Original policy ↗
Adult Peripheral Nerve Disorders Imaging PolicyCommercial, Medicaid—Original policy ↗
Adult Peripheral Vascular Disease Imaging PolicyCommercial, Medicaid31Original policy ↗
Adult Spine Imaging PolicyCommercial, Medicaid39Original policy ↗
Aerosolized Antibiotics as a Treatment of Chronic SinusitisCommercial, Medicaid—Original policy ↗
Afamelanotide (Scenesse)Commercial—Original policy ↗
After-hours and Weekend CareEffective Nov 1, 2013 · Commercial, Medicaid6Original policy ↗
Agalsidase Beta (Fabrazyme)Commercial—Original policy ↗
Alcohol Injections for Treatment of Peripheral NeuromasCommercial, Medicaid—Original policy ↗
Alkylating Agent(s) [Temozolomide intravenous (Temodar®)]Commercial—Original policy ↗
Allergen ImmunotherapyCommercial, Medicaid—Original policy ↗
Allergy ServicesEffective Dec 1, 2023 · Commercial1Original policy ↗
Allergy TestingCommercial, Medicaid1Original policy ↗
Allogeneic Hematopoietic Cell Transplantation for Genetic Diseases and Acquired AnemiasCommercial, Medicaid—Original policy ↗
Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative NeoplasmsCommercial, Medicaid—Original policy ↗
Allogeneic Pancreas TransplantCommercial, Medicaid—Original policy ↗
Alpha 1-Proteinase Inhibitors (Human) [Prolastin-C®, Aralast NP®, Zemaira®, Glassia®]Commercial—Original policy ↗
Alpha-Fetoprotein-L3 for Detection of Hepatocellular (Liver) CancerCommercial, Medicaid1Original policy ↗
Ambulance and Medical Transport Services/ Ancillary Ambulance Items and SuppliesCommercial, Medicaid—Original policy ↗
Ambulance ServicesEffective Jan 1, 2020 · Commercial20Original policy ↗
Ambulatory Event Monitors and Mobile Cardiac Outpatient TelemetryCommercial, Medicaid—Original policy ↗
Amniotic Membrane and Amniotic FluidCommercial, Medicaid—Original policy ↗
Analysis of MGMT Promoter Methylation in Malignant GliomasCommercial, Medicaid—Original policy ↗
Analysis of Proteomic Patterns in Serum to Identify CancerCommercial, Medicaid—Original policy ↗
Anesthesia Care During Interventional Pain Management ProceduresCMM-400 · Commercial, Medicaid5Original policy ↗
Anesthesia Reimbursement GuidelinesEffective Nov 1, 2007 · Commercial16Original policy ↗
Angiogenic Inhibitors for the Treatment of Ophthalmic Macular ConditionsCommercial1Original policy ↗
Antigen Leukocyte Antibody TestCommercial—Original policy ↗
Antineoplaston TherapyCommercial, Medicaid—Original policy ↗
Applied Behavior Analysis in the Treatment of Autism Spectrum DisordersEffective Sep 11, 2024 · Commercial, Medicaid11Original policy ↗

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Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.