| Casgevy (exagamglogene autotemcel) for Beta Thalassemia | 449 · Effective Aug 12, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| Casgevy (exagamglogene autotemcel) for Sickle Cell Disease | 447 · Effective Aug 12, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| Casgevy (exagamglogene autotemcel) Sickle Cell Disease, IL_Appendix (Medicaid): Policy No. 447 | 447 · Medicaid · IL | 3 | Original policy ↗ |
| Category III CPT Codes | Commercial, Medicaid | 214 | Original policy ↗ |
| Cayston (aztreonam) MHI | Medicaid · IL, MS | — | Original policy ↗ |
| Cerdelga (eliglustat) MHI | Medicaid · IL, MS | — | Original policy ↗ |
| CGRP Antagonists IL Medicaid Only C17186-C | C17186-C · Medicaid · IL | 1 | Original policy ↗ |
| Cholbam (cholic acid) MHI | Medicaid · IL, MS | — | Original policy ↗ |
| Cibinqo (abrocitinib) MHI | Medicaid · IL, MS | — | Original policy ↗ |
| Cimzia (certolizumab pegol) MHI | Medicaid · IL, MS | — | Original policy ↗ |
| Cinqair (reslizumab) MHI | Medicaid · IL, MS | 1 | Original policy ↗ |
| Clinical Determinations of Appropriate Level of Care | MHI-Healthcare Services-394 · Effective May 2, 2016 · Commercial, Medicaid | — | Original policy ↗ |
| Clinical Diagnostic Laboratory Services | Commercial | 211 | Original policy ↗ |
| Clinical Diagnostic Laboratory Services | | 212 | Original policy ↗ |
| Clinical Trials and Rare Disease Policy | Commercial, Medicaid | 9 | Original policy ↗ |
| CMS Replacement Codes | Commercial, Medicaid | — | Original policy ↗ |
| CNS Stimulants, IL Medicaid Only | C21108-A · Effective Apr 28, 2021 · Medicaid · IL | — | Original policy ↗ |
| Co Surgeon Team Surgeon Professional | Commercial, Medicaid | 2 | Original policy ↗ |
| Co Surgeon Team Surgeon Professional | Medicaid · AZ, FL, IA, ID, IL, MI, NE, NM, NY, OH, SC, TX, UT, WI | 2 | Original policy ↗ |
| Coding Policy General | Medicaid · IL | — | Original policy ↗ |
| Colcrys, Mitigare, Gloperba (colchicine) MHI | Medicaid · IL, MS | — | Original policy ↗ |
| Colonoscopy and Sigmoidoscopy | Commercial | 35 | Original policy ↗ |
| Condition Codes 49, 50, and 53 | Commercial, Medicaid | — | Original policy ↗ |
| Constipation Agents MHI | Medicaid · IL, MS | 1 | Original policy ↗ |
| Continous Glucose Monitoring IL Medicaid Only C22081-A | C22081-A · Medicaid · IL | — | Original policy ↗ |
| Cooled Radiofrequency Ablation (CRFA) for the Management of Chronic Pain | 386 · Commercial, Medicaid | 7 | Original policy ↗ |
| Copaxone/Glatopa (glatiramer acetate) MHI | Medicaid · IL, MS | — | Original policy ↗ |
| Corneal Collagen Cross-Linking (CXL) | 328 · Effective Aug 12, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| Corrected Claims | Commercial | — | Original policy ↗ |
| Cosela (trilaciclib) MHI | Medicaid · IL, MS | 1 | Original policy ↗ |
| Cosentyx (secukinumab) MHI | Medicaid · IL, MS | 1 | Original policy ↗ |
| Cranial Orthotic Devices | Commercial | 3 | Original policy ↗ |
| Critical Care Codes when Discharging Home from the ED | 38 · Effective Aug 4, 2022 · Medicaid · IL | 2 | Original policy ↗ |
| Critical Care Codes when Discharging Home from the Emergency Department | Commercial | 2 | Original policy ↗ |
| Critical Care Codes when Discharging Home from the Emergency Department | Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI | 2 | Original policy ↗ |
| Cross-Departmental Recovery Policy | Medicaid | — | Original policy ↗ |
| Crysvita (Burosumab-twza) MHI | Medicaid · IL, MS | 1 | Original policy ↗ |
| CT Computed Tomography of the Abdomen and Pelvis | Commercial | — | Original policy ↗ |
| Cuvposa (glycopyrrolate) Oral Solution MHI | Medicaid · IL, MS | — | Original policy ↗ |
| Cystic Fibrosis Agents (Kalydeco, Orkambi, Symdeko, Trikafta) MHI | Medicaid · IL, MS | — | Original policy ↗ |
| Cytogam (cytomegalovirus immune globulin) MHI | Medicaid · IL, MS | 1 | Original policy ↗ |
| D M E Place of Service 31 or 32 | Effective Aug 6, 2025 · Medicaid | — | Original policy ↗ |
| D R G (DRG) Clinical Validation | Effective Aug 1, 2025 · Commercial, Medicaid | — | Original policy ↗ |
| D R G (DRG) Clinical Validation | Effective Aug 1, 2025 · Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI | — | Original policy ↗ |
| Dalvance (dalbavancin) MHI | Medicaid · IL, MS | 1 | Original policy ↗ |
| Daraprim (pyrimethamine) MHI | Medicaid · IL, MS | — | Original policy ↗ |
| Daybue (trofinetide) MHI | Medicaid · IL, MS | — | Original policy ↗ |
| Decision for Surgery | Medicaid · IL | — | Original policy ↗ |
| Decision for Surgery Modifier 57 | Commercial, Medicaid | — | Original policy ↗ |
| Decision for Surgery Modifier 57 | Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI | — | Original policy ↗ |
