| Prolotherapy | Effective Aug 1, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Quantitative Electroencephalogram (qEEG) and Referenced Electroencephalogram (rEEG) | Effective Jun 1, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Quantitative Sensory Tests | Effective Aug 1, 2026 · Commercial, Medicaid | 5 | Original policy ↗ |
| Radioembolization for Hepatic Tumors | Effective Feb 1, 2017 · Commercial, Medicaid | 4 | Original policy ↗ |
| Radiofrequency Ablation of Uterine Fibroids | Effective Sep 1, 2026 · Commercial, Medicaid | 2 | Original policy ↗ |
| Radiofrequency Spectroscopy for Intra-Operative Assessment of Surgical Margins in Breast Cancer (e.g., MarginProbe) | Effective Mar 1, 2026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Radiofrequency Volumetric Tissue Reduction (RFVTR) for Obstructive Sleep Apnea | Effective Oct 1, 2025 · Commercial, Medicaid | 1 | Original policy ↗ |
| Rebundling - Professional | RP-P-320X · Effective Nov 1, 1999 · Commercial, Medicaid | — | Original policy ↗ |
| Recalled or Replaced Medical Devices | RP-F-325X · Effective Feb 1, 2009 · Commercial, Medicaid | — | Original policy ↗ |
| Recombinant Human Bone Morphogenic Protein-2 (rhBMP-2)/InFUSE (Long Bones) and Allogeneic Morphogenic Protein (e.g., Osteo-AMP™) | Effective Feb 1, 2026 · Commercial, Medicaid | — | Original policy ↗ |
| Reconstructive and Cosmetic Health Services | Effective Jan 1, 2026 · Commercial, Medicaid | 37 | Original policy ↗ |
| Registered Dietitian and Home Health Specialties Billing Evaluation and Management Codes | Effective Mar 14, 2010 · Commercial, Medicaid | 13 | Original policy ↗ |
| Reimbursement Modifier Reference Guide | Commercial, Medicaid | — | Original policy ↗ |
| Reimbursement Place of Service (POS) Code Reference Guide | Commercial, Medicaid | — | Original policy ↗ |
| Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) | Effective May 1, 2026 · Commercial, Medicaid | 10 | Original policy ↗ |
| Replacement Codes | RP-P-580X · Effective Nov 1, 2025 · Commercial | 5 | Original policy ↗ |
| Residential Facility and Outpatient Urine Drug Testing (UDT), Presumptive and Definitive | Effective Jun 1, 2026 · Commercial, Medicaid | — | Original policy ↗ |
| Sacral Nerve Stimulation | Effective Sep 1, 2026 · Commercial, Medicaid | 12 | Original policy ↗ |
| Salivary Estriol Test for Preterm Labor | Effective Aug 1, 2026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Salivary Hormone Tests | Effective Nov 16, 2020 · Commercial, Medicaid | 1 | Original policy ↗ |
| Same Day Same Service | RP-P-345X · Effective Jun 1, 1988 · Commercial, Medicaid | 2 | Original policy ↗ |
| Scanning Laser Technologies for Retina and Optic Nerve Imaging | Effective Sep 1, 2026 · Commercial, Medicaid | 8 | Original policy ↗ |
| Scar Revision | Effective Sep 1, 2026 · Commercial, Medicaid | 10 | Original policy ↗ |
| Scintimammography | Effective Jan 1, 2026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Scrambler Pain Therapy | Effective Jan 20, 2020 · Commercial, Medicaid | 1 | Original policy ↗ |
| Self-Administered Drugs | RP-P-350X · Effective Jul 1, 2008 · Commercial, Medicaid | 2 | Original policy ↗ |
| Sensory and Auditory Integration Therapies | Effective Oct 1, 2025 · Commercial, Medicaid | 1 | Original policy ↗ |
| Serial Dilution Endpoint Titration for Diagnosis and Treatment of Airborne Allergy | Effective Jan 1, 2026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Serious Reportable Events | RP-PF-355X · Effective Feb 11, 2008 · Commercial, Medicaid | — | Original policy ↗ |
| Services and Modifiers Not Reimbursable to Health Care Professionals | RP-P-360X · Effective Nov 15, 2014 · Commercial, Medicaid | — | Original policy ↗ |
| Services Incidental to Admission | RP-F-365X · Effective Sep 1, 2014 · Commercial, Medicaid | — | Original policy ↗ |
| Single Photon Emission Computed Tomography (SPECT) for Attention Deficit Hyperactivity Disorder (ADHD) | Effective Aug 1, 2026 · Commercial, Medicaid | 1 | Original policy ↗ |
| Skin and Soft Tissue-Engineered Substitutes for Wound and Surgical Care | Effective Mar 1, 2026 · Commercial, Medicaid | 300 | Original policy ↗ |
| Sleep Studies for Initial Diagnosis of Obstructive Sleep Apnea | Effective Oct 1, 2025 · Commercial, Medicaid | 12 | Original policy ↗ |
| Sphenopalatine Ganglion Block for the Treatment of Headache | Effective Dec 1, 2025 · Commercial, Medicaid | 1 | Original policy ↗ |
| Split Surgical Package | RP-P-370X · Effective Nov 1, 2004 · Commercial, Medicaid | — | Original policy ↗ |
| Standby Services | RP-P-375X · Effective Aug 16, 2009 · Commercial, Medicaid | 3 | Original policy ↗ |
| Stem Cell and Cellular Bone Matrix Products for Orthopedic Applications | Effective Sep 1, 2026 · Commercial, Medicaid | 7 | Original policy ↗ |
| Stem Cell Therapy for Peripheral Artery Disease | Effective Sep 1, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| SU Modifier | RP-P-380X · Effective Aug 14, 2011 · Commercial, Medicaid | — | Original policy ↗ |
| Subacromial Tissue Spacer for Treatment of Rotator Cuff | Effective Feb 20, 2023 · Commercial, Medicaid | 1 | Original policy ↗ |
| Supply | RP-P-385X · Effective Nov 14, 2010 · Commercial, Medicaid | 3 | Original policy ↗ |
| Surgical and Minimally Invasive Treatments for Benign Prostatic Hypertrophy/Hyperplasia (BPH) | Effective Dec 1, 2025 · Commercial, Medicaid | 33 | Original policy ↗ |
| Surgical Interruption of Pelvic Nerve Pathways for Treatment of Pelvic Pain (e.g., Presacral Neurectomy and Uterosacral Nerve) | Effective Oct 16, 2023 · Commercial, Medicaid | — | Original policy ↗ |
| Synthetic Cartilage Implants (Cartiva SCI) for First Metatarsophalangeal Joint | Effective Sep 1, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| Synthetic Ceramic-Based and Bioactive Glass Bone Substitutes/Fillers | Effective Jan 1, 2026 · Commercial, Medicaid | 7 | Original policy ↗ |
| T-Status Codes | RP-P-315X · Effective Mar 1, 2023 · Commercial, Medicaid | 8 | Original policy ↗ |
| Team Conferences | RP-P-390X · Effective Jun 1, 2007 · Commercial | 3 | Original policy ↗ |
| Technology Assisted Surgical Techniques | RP-P-340X · Effective Mar 14, 2010 · Commercial | 4 | Original policy ↗ |
| Telehealth | Effective Sep 1, 2026 · Commercial, Medicaid | — | Original policy ↗ |
