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Molina Healthcare California policies, page 7

Search Molina Healthcare California'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.

360 public policies Substrate tracks for Molina Healthcare California, by title.

Molina Healthcare California policies
PolicyDetailsCodesSource
Scenesse (afamelanotide) Implant: MEDICARE367b · Effective Apr 15, 20261Original policy ↗
Sclerotherapy and Adhesive Therapy for Varicose VeinsCommercial, Medicaid8Original policy ↗
Self Administered DrugsCommercial, Medicaid137Original policy ↗
Semiprivate Versus (Vs) Private RoomEffective Aug 19, 2025 · Commercial—Original policy ↗
SepsisCommercial, Medicaid—Original policy ↗
SepsisMedicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI—Original policy ↗
Skin and Soft Tissue Substitutes357 · Commercial, Medicaid392Original policy ↗
Skin and Soft Tissue Substitutes MEDICARE392Original policy ↗
Skysona (elivaldogene autotemcel)Commercial, Medicaid3Original policy ↗
Sleep Apnea or Snoring (eXciteObstructive Sleep Apnea (OSA)): MEDICARE422b2Original policy ↗
Small Bowel Multivisceral TransplantationCommercial, Medicaid24Original policy ↗
Smart Watch Photoplethysmography (PPG) for Detection of Atrial Fibrillation341 · Commercial6Original policy ↗
Specimen Validity TestingEffective Aug 29, 2025 · Commercial12Original policy ↗
Specimen Validity TestingEffective Sep 8, 2023 · Medicaid8Original policy ↗
Specimen Validity TestingEffective Aug 29, 2025 · Medicaid · AZ, CA, IA, NE12Original policy ↗
Speech Generating DevicesCommercial, Medicaid13Original policy ↗
Speech Therapy for Feeding DisordersCommercial, Medicaid10Original policy ↗
Spinraza (nusinersen)293 · Commercial, Medicaid2Original policy ↗
Split-Night-Sleep-StudyCommercial, Medicaid5Original policy ↗
Split-Night-Sleep-Study7Original policy ↗
Split-Night-Sleep-StudyMedicaid · AZ, CA, FL, IA, ID, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI5Original policy ↗
Status Indicator Flag B Bundled CodesCommercial, Medicaid—Original policy ↗
Steerable Ureteroscopic Renal Evacuation477 · Commercial, Medicaid1Original policy ↗
Steerable Ureteroscopic Renal Evacuation (SURE): MEDICARE477b · Effective Dec 17, 20251Original policy ↗
Stem Cell Therapy for Orthopedic Applications426 · Effective Oct 8, 2025 · Commercial, Medicaid26Original policy ↗
Steroid-Eluting Sinus Stents and Implants (PROPEL, SINUVA)333 · Commercial4Original policy ↗
STI Lab Panel TestingCommercial, Medicaid8Original policy ↗
Tecartus (brexucabtagene autoleucel)378 · Commercial, Medicaid5Original policy ↗
Tecelra (afamitresgene autoleucel)Commercial, Medicaid3Original policy ↗
Tendon Injections Missing DiagnosisEffective Aug 20, 2025 · Commercial, Medicaid4Original policy ↗
Tendon Injections Missing DiagnosisEffective Aug 20, 2025 · Medicaid · AZ, CA, FL, IA, ID, NE, NM, OH, SC, TX, UT, WI4Original policy ↗
Therapy Modifier CodingCommercial, Medicaid—Original policy ↗
Therapy Modifier Coding—Original policy ↗
Therapy Modifier CodingMedicaid · AZ, CA, FL, IA, MA, MI, NE, NM, NY—Original policy ↗
Thermography and BSGI Imaging for the Detection of Breast Lesions127 · Commercial5Original policy ↗
Topical and Intralesional TherapiesCommercial, Medicaid12Original policy ↗
Topical Oxygen TherapyCommercial1Original policy ↗
Transcatheter Mitral Valve Implantation437 · Commercial, Medicaid2Original policy ↗
Tregzi (allogeneic regulatory T cell immunotherapy with HSPC and T cells-vldq)Commercial, Medicaid5Original policy ↗
Tudriqev (vusolimogene oderparepec)486 · Effective Aug 12, 2026 · Commercial, Medicaid4Original policy ↗
Tudriqev (vusolimogene oderparepec): MEDICARE486b · Effective Aug 19, 20264Original policy ↗
Unlisted CodingCommercial, Medicaid25Original policy ↗
Unspecified Codes in an Inpatient SettingCommercial—Original policy ↗
Unspecified Codes in an Inpatient SettingMedicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI—Original policy ↗
Visudyne (verteporfin) for Ocular Photodynamic Therapy308 · Commercial, Medicaid4Original policy ↗
Vyjuvek (beremagene geperpavec)Commercial, Medicaid1Original policy ↗
Waskyra (etuvetidigene autotemcel)Commercial, Medicaid5Original policy ↗
Waskyra (etuvetidigene autotemcel) MEDICARE5Original policy ↗
Water Vapor Thermal Therapy for BPH384 · Commercial, Medicaid1Original policy ↗
Wearable Cardioverter-Defibrillator Devices451 · Commercial, Medicaid6Original 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.

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