| 3D Interpretation and Reporting of Imaging Studies | Commercial, Medicaid | 56 | Original policy ↗ |
| 3D Interpretation and Reporting of Imaging Studies MEDICARE | | 56 | Original policy ↗ |
| Abecma (idecabtagene vicleucel) | Commercial, Medicaid | 9 | Original policy ↗ |
| Accurate Billing Start and end Dates | Medicaid · AZ, NE | 6 | Original policy ↗ |
| Actigraphy | Commercial, Medicaid | 1 | Original policy ↗ |
| Add On Coding Policy | Medicaid | 11 | Original policy ↗ |
| Add-on Coding | Commercial, Medicaid | 11 | Original policy ↗ |
| Add-on Coding | Medicaid · AZ, FL, ID, IL, MA, NE, NM, NV, NY, SC, TX, UT, WA | 11 | Original policy ↗ |
| Adstiladrin (nadofaragene firadenovec vncg) | Commercial, Medicaid | 1 | Original policy ↗ |
| Adstiladrin (nadofaragene firadenovec vncg) MEDICARE | | 1 | Original policy ↗ |
| Advanced Beneficiary Notice ABN Modifiers GA GX GY GZ | Commercial | — | Original policy ↗ |
| Advanced Beneficiary Notice ABN Modifiers GA GX GY GZ | Effective Oct 23, 2023 | — | Original policy ↗ |
| Advanced Beneficiary Notice ABN Modifiers GA GX GY GZ | Effective Oct 23, 2023 · Medicaid · FL, ID, NE, OH, SC, TX, UT, WI | — | Original policy ↗ |
| After Hours and Weekend Care Policy | Effective Jul 30, 2025 · Commercial, Medicaid | 7 | Original policy ↗ |
| After Hours and Weekend Care Policy | Effective Dec 12, 2023 · Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NV, NY, OH, SC, TX, WA, WI | 7 | Original policy ↗ |
| Allergy Testing | Commercial, Medicaid | — | Original policy ↗ |
| Allergy Testing | Medicaid · AZ, IA, ID, MI, NE, OH, SC, TX, WI | — | Original policy ↗ |
| Allogeneic Pancreatic Islet Cell Transplantation with Lantidra (donislecel-jujn) | 441 · Effective Aug 12, 2026 · Commercial | 12 | Original policy ↗ |
| Allogeneic Processed Thymus Tissue–agdc (Rethymic) | Commercial | 3 | Original policy ↗ |
| Allogeneic Processed Thymus Tissue–agdc (Rethymic) MEDICARE | 472b | 3 | Original policy ↗ |
| Ambulance Modifier | Commercial, Medicaid | 6 | Original policy ↗ |
| Ambulance Modifier | Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NV, NY, OH, SC, TX, WA, WI | 6 | Original policy ↗ |
| Ambulatory and Video EEG Monitoring | Commercial, Medicaid | 23 | Original policy ↗ |
| Ambulatory Echocardiograph Monitoring | Medicaid | — | Original policy ↗ |
| Ambulatory Echocardiograph Monitoring | Medicaid · ID, NE, NV, OH, SC, TX | — | Original policy ↗ |
| Amtagvi (lifileucel) | Commercial | 4 | Original policy ↗ |
| Anesthesia Bundling | Commercial | 11 | Original policy ↗ |
| Anesthesia Bundling | Medicaid · AZ, FL, IA, ID, MI, NE, OH, TX, UT, WI | 11 | Original policy ↗ |
| Annual Wellness Visit sooner than 11 months following Initial (IPPE) Policy | Effective Jul 30, 2025 · Medicaid | 3 | Original policy ↗ |
| Annual Wellness Visit sooner than 11 months following Initial (IPPE) Policy | Effective Jul 30, 2025 · Medicaid · AZ, IA, ID, NE, OH, SC, TX, WI | 3 | Original policy ↗ |
| Aortography and Peripheral Angiography | Commercial, Medicaid | — | Original policy ↗ |
| Aortography and Peripheral Angiography | Medicaid · AZ, IA, ID, MI, NE, NV, OH, SC, TX, WI | — | Original policy ↗ |
| Applied Behavioral Analysis for Autism Spectrum Disorder | Commercial, Medicaid | 12 | Original policy ↗ |
| Arterially Directed Embolic Therapy for Liver Tumors (example (e.g.), T A C E, T A E, D E B-TACE) | 120 · Effective Apr 8, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| ASC Groupers | Commercial | 256 | Original policy ↗ |
| Aucatzyl (obecabtagene autoleucel) | 462 · Commercial | 5 | Original policy ↗ |
| Authorization Review | Commercial, Medicaid | — | Original policy ↗ |
| Authorization Review | Medicaid | — | Original policy ↗ |
| Authorization Review | Medicaid · AZ, NE | — | Original policy ↗ |
| Authorized Pain Management Services with a Claim Modifier Mismatch | Effective Apr 26, 2024 · Commercial, Medicaid | 46 | Original policy ↗ |
| Autofluorescence Wound Imaging Device (MolecuLight and Multispectral Imager) | Commercial, Medicaid | 2 | Original policy ↗ |
| Autologous Chondrocyte Implantation Knee | 347 · Commercial | 4 | Original policy ↗ |
| Autologous Pancreatic Islet Cell Transplantation | 440 · Effective Aug 12, 2026 · Commercial, Medicaid | 12 | Original policy ↗ |
| Autonomic Function Testing | Medicaid · AZ, IA, ID, MI, NE, NV, OH, SC, TX, WI | — | Original policy ↗ |
| Autonomic FunctionTesting | Commercial | — | Original policy ↗ |
| Back Braces | Commercial, Medicaid | 90 | Original policy ↗ |
| Balloon Sinus Ostial Dilation Balloon Sinuplasty | 408 · Commercial, Medicaid | 5 | Original policy ↗ |
| Blepharoplasty, Blepharoptosis Repair, and Brow Ptosis Repair | Commercial, Medicaid | 12 | Original policy ↗ |
| Bone Graft Substitutes for Bone Fusion | Commercial, Medicaid | 2 | Original policy ↗ |
| Brain PET | Commercial, Medicaid | 4 | Original policy ↗ |
