Medica policy
Reconstructive and Cosmetic Health Services
Reconstructive and Cosmetic Health Services is a public Medica policy (effective Jan 1, 2026). It lists 37 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
- Payer
- Medica
- Effective
- Jan 1, 2026
- Line of business
- Commercial, Medicaid
- Source
- partner.medica.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other Medica policies |
|---|---|
| 0419T | Policies naming 0419T |
| 0420T | Policies naming 0420T |
| 11055 | Policies naming 11055 |
| 11056 | Policies naming 11056 |
| 11057 | Policies naming 11057 |
| 11920 | Policies naming 11920 |
| 11921 | Policies naming 11921 |
| 11922 | Policies naming 11922 |
| 11950 | Policies naming 11950 |
| 11951 | Policies naming 11951 |
| 11952 | Policies naming 11952 |
| 11954 | Policies naming 11954 |
| 15775 | Policies naming 15775 |
| 15776 | Policies naming 15776 |
| 15780 | Policies naming 15780 |
| 15781 | Policies naming 15781 |
| 15782 | Policies naming 15782 |
| 15783 | Policies naming 15783 |
| 15786 | Policies naming 15786 |
| 15787 | Policies naming 15787 |
| 15788 | Policies naming 15788 |
| 15789 | Policies naming 15789 |
| 15792 | Policies naming 15792 |
| 15793 | Policies naming 15793 |
| 15824 | Policies naming 15824 |
| 15825 | Policies naming 15825 |
| 15826 | Policies naming 15826 |
| 15828 | Policies naming 15828 |
| 15829 | Policies naming 15829 |
| 17106 | Policies naming 17106 |
| 17107 | Policies naming 17107 |
| 17108 | Policies naming 17108 |
| 17360 | Policies naming 17360 |
| 21270 | Policies naming 21270 |
| 69090 | Policies naming 69090 |
| 69300 | Policies naming 69300 |
| Q2028 | Policies naming Q2028 |