| Mechanical Stretching Devices for the Treatment of Joint Contractures of the Extremities | Effective Feb 1, 2026 · Commercial, Medicaid | 32 | Original policy ↗ |
| Mechanical Stretching Devices – Minnesota Medical Assistance Members | Effective Jul 1, 2026 · Medicaid | 33 | Original policy ↗ |
| Mechanized Spinal Decompression Traction Tables for Low Back Pain | Effective Jan 1, 2005 · Commercial, Medicaid | 1 | Original policy ↗ |
| Meibomian Gland Evacuation Therapies | Effective Apr 1, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| Microsurgery | RP-P-235X · Effective Nov 1, 1999 · Commercial, Medicaid | 2 | Original policy ↗ |
| mild® Procedure (mild® Device Kit) | Effective Apr 1, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Modifier Reductions | RP-P-330X · Effective Mar 1, 2023 · Commercial, Medicaid | — | Original policy ↗ |
| Motion Preserving Posterior Interspinous/Interlaminar Decompression/Stabilization Devices | Effective Oct 1, 2025 · Commercial, Medicaid | 6 | Original policy ↗ |
| MPPR for Diagnostic Cardiovascular and Ophthalmology Procedures | RP-P-250X · Effective Feb 1, 2019 · Commercial, Medicaid | — | Original policy ↗ |
| Multichannel Intraluminal Esophageal Impedance with pH Monitoring | Effective Jun 1, 2026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Multiple Procedure Payment Reduction for Diagnostic Imaging | RP-P-250X · Effective May 21, 2016 · Commercial, Medicaid | 22 | Original policy ↗ |
| Multiple Procedure Reduction | RP-P-255X · Effective Apr 1, 1999 · Commercial, Medicaid | — | Original policy ↗ |
| Myocardial Strain Imaging | Effective Dec 20, 2023 · Commercial, Medicaid | 1 | Original policy ↗ |
| Myoelectric Upper Limb Prosthetics and Orthotics | Effective Sep 1, 2026 · Commercial, Medicaid | 34 | Original policy ↗ |
| Nasal Expiratory Positive Airway Pressure (Provent®) for Obstructive Sleep Apnea | Effective Aug 19, 2019 · Commercial, Medicaid | 2 | Original policy ↗ |
| Nasal Implant, Absorbable, for Treatment of Nasal Valve Collapse | Effective Apr 1, 2026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Nebulized Intranasal Antibiotics/Antifungals for Sinusitis | Effective Oct 1, 2025 · Commercial, Medicaid | 1 | Original policy ↗ |
| Negative Pressure Wound Therapy with Instillation Systems | Effective Dec 1, 2025 · Commercial, Medicaid | 11 | Original policy ↗ |
| New Patient Visit | RP-P-260X · Effective Jan 1, 2022 · Commercial, Medicaid | — | Original policy ↗ |
| New Patient Visit | RP-P-580X · Effective Feb 13, 2012 · Commercial, Medicaid | 10 | Original policy ↗ |
| New-to-Market Medical Pharmacy Products | Effective Nov 1, 2025 · Commercial, Medicaid | 6 | Original policy ↗ |
| New-to-Market Medical Pharmacy Products Currently Under Clinical Review | Effective Aug 20, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| Nidra (Noctrix Health) System and Tonic Motor Activation (TOMAC) System for treating Restless Legs Syndrome (RLS) | Effective Aug 1, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Non-Invasive Measurement of Left Ventricular End Diastolic Pressure | Effective Dec 1, 2025 · Commercial, Medicaid | 1 | Original policy ↗ |
| Non-Pneumatic Compression Systems or Garments (e.g., Dayspring) | Effective Jan 1, 2026 · Commercial, Medicaid | 6 | Original policy ↗ |
| Non-Powered or Single Use Negative Pressure Wound Therapy Systems | Effective Nov 1, 2025 · Commercial, Medicaid | 3 | Original policy ↗ |
| Noncontact Near Infrared Spectroscopy | Effective Aug 1, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Noncontact Normothermic Wound Therapy | Effective Feb 1, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| Noncontact, Low-frequency Ultrasound Therapy for Healing of Chronic Wounds | Effective Oct 1, 2025 · Commercial, Medicaid | 1 | Original policy ↗ |
| Nonphysician Health Care Codes | RP-P-265X · Effective Oct 30, 2006 · Commercial, Medicaid | 15 | Original policy ↗ |
| Nutritional Counseling | Effective May 1, 2026 · Commercial, Medicaid | 16 | Original policy ↗ |
| Observation | RP-F-500M · Effective Aug 1, 2021 · Commercial, Medicaid | 8 | Original policy ↗ |
| Obstetrical | RP-P-270X · Effective Jan 1, 2002 · Commercial, Medicaid | 56 | Original policy ↗ |
| Once in a Lifetime Procedures | RP-P-275X · Effective Nov 14, 2010 · Commercial, Medicaid | — | Original policy ↗ |
| One or More Sessions | RP-P-280X · Effective Jun 1, 2011 · Commercial, Medicaid | — | Original policy ↗ |
| Oscillating Lung Expansion Systems (e.g., Volara; BiWaze Clear) | Effective Dec 1, 2025 · Commercial, Medicaid | 4 | Original policy ↗ |
| Outpatient Drug Treatment and Vaccinations for COVID-19 | RP-PF-450X · Effective Dec 31, 2020 · Commercial, Medicaid | 90 | Original policy ↗ |
| Palatal Implants for Obstructive Sleep Apnea | Effective Sep 1, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Pelvic Vein Embolization | Effective Feb 1, 2026 · Commercial, Medicaid | 4 | Original policy ↗ |
| Percutaneous Disc Decompression Procedures (Percutaneous Discectomies, Nucleoplasty) | Effective Aug 1, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Percutaneous Neuromodulation Therapy (PNT) for the Treatment of Pain | Effective Apr 1, 2026 · Commercial, Medicaid | 5 | Original policy ↗ |
| Percutaneous Tibial Nerve Stimulation | Effective Jan 1, 2026 · Commercial, Medicaid | 6 | Original policy ↗ |
| Percutaneous Ultrasonic Ablation of Soft Tissue | Effective Dec 1, 2025 · Commercial, Medicaid | 2 | Original policy ↗ |
| Photodynamic Therapy with Visudyne® (verteporfin) for Ocular Indications | Effective Jul 1, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| Phrenic Nerve Stimulation for Central Sleep Apnea | Effective Jun 1, 2026 · Commercial, Medicaid | 10 | Original policy ↗ |
| Physical Medicine & Rehabilitation – Multiple Therapy Procedure Reduction | RP-P-285X · Effective Feb 14, 2015 · Commercial, Medicaid | — | Original policy ↗ |
| Powered Robotic Lower-Limb Exoskeleton Devices for Home Use | Effective Oct 1, 2025 · Commercial, Medicaid | 5 | Original policy ↗ |
| Preventive Medicine and Screening | RP-P-300X · Effective Dec 1, 2005 · Commercial, Medicaid | 43 | Original policy ↗ |
| Professional and Technical Components | RP-P-305X · Effective May 1, 1999 · Commercial, Medicaid | 2 | Original policy ↗ |
| Prolonged Services | RP-P-310X · Effective Jul 1, 2007 · Commercial, Medicaid | 22 | Original policy ↗ |
