| NPFS Status Indicator T | Medicaid | — | Original policy ↗ |
| NPFS Status Indicator T | Medicaid · AZ, CA, FL, IA, ID, MA, MI, NE, SC, TX, UT, WI | — | Original policy ↗ |
| Observation | Commercial | 17 | Original policy ↗ |
| Observation | | 17 | Original policy ↗ |
| Observation | Medicaid · AZ, FL, IA, ID, IL, MI, NE, NY, OH, SC, TX, UT, WA, WI | 17 | Original policy ↗ |
| Occupational Therapy | 409 · Commercial, Medicaid | 28 | Original policy ↗ |
| Omisirge (omidubicel onlv) | Commercial, Medicaid | 5 | Original policy ↗ |
| Opioid Treatment Service | Medicaid | 18 | Original policy ↗ |
| Opioid Treatment Service | Medicaid · AZ, IA, ID, NE, OH, SC, TX, WI | 18 | Original policy ↗ |
| Optum EDC Analyzer - Facility ER E&M Leveling Prepayment | Commercial, Medicaid | 6 | Original policy ↗ |
| Optum EDC Analyzer - Facility ER E&M Leveling Prepayment | Medicaid · AZ, CA, FL, IA, ID, MA, MI, NE, NM, NY, SC, TX, UT, WA, WI | 6 | Original policy ↗ |
| Optum Pause and Pay | Medicaid | — | Original policy ↗ |
| Otarmeni (lunsotogene parvec) | 485 · Commercial | 3 | Original policy ↗ |
| Otarmeni (lunsotogene parvec) MEDICARE | 485b | 3 | Original policy ↗ |
| Overlapping Room and Board | Commercial | — | Original policy ↗ |
| Overlapping Room and Board | Medicaid · AZ, FL, IA, ID, MI, NE, OH, SC, TX, WI | — | Original policy ↗ |
| P T/O T/S T (PT/OT/ST) Yearly Limit | Effective Aug 19, 2025 · Medicaid · AZ, IA, ID, MI, NE, SC, TX, UT, WI | — | Original policy ↗ |
| Packaged and conditionally packaged lab services | Commercial | — | Original policy ↗ |
| Packaged and conditionally packaged lab services | Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, WA, WI | — | Original policy ↗ |
| Paid Amount Exceeded Billed Amount | Effective Jul 30, 2025 · Commercial, Medicaid | — | Original policy ↗ |
| Paid Amount Exceeded Billed Amount | Effective Jul 30, 2025 · Medicaid · IA, ID, MI, OH, SC, TX, WI | — | Original policy ↗ |
| Pancreas Transplantation | Effective Apr 23, 2021 · Commercial, Medicaid | 20 | Original policy ↗ |
| Papzimeos (zopapogene imadenovec) | Commercial, Medicaid | 1 | Original policy ↗ |
| Papzimeos (zopapogene imadenovec) MEDICARE | | 1 | Original policy ↗ |
| Percutaneous Electrical Nerve Field Stimulation for Abdominal Pain | Commercial | 4 | Original policy ↗ |
| Percutaneous Epidural Adhesiolysis | 257 · Commercial | 2 | Original policy ↗ |
| Percutaneous Image-Guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis | Commercial | 4 | Original policy ↗ |
| Percutaneous Ventricular Assist Devices | 132 · Commercial, Medicaid | 6 | Original policy ↗ |
| Perirectal Spacer for Prostate Radiotherapy | 425 · Commercial | 1 | Original policy ↗ |
| Peroral Endoscopic Myotomy for Esophageal Achalasia | 385 · Commercial, Medicaid | 2 | Original policy ↗ |
| Phototherapy, Photochemotherapy, and Laser Therapy for Dermatological Conditions | 292 · Commercial, Medicaid | 12 | Original policy ↗ |
| Physician Office Laboratory Testing | Commercial, Medicaid | 60 | Original policy ↗ |
| Physician Office Laboratory Testing | Medicaid | 211 | Original policy ↗ |
| Physician Office Laboratory Testing | Medicaid · AZ, CA, FL, IA, ID, IL, MA, NE, NM, NY, OH, SC, TX, WA, WI | 60 | Original policy ↗ |
| Plantar Fasciitis Surgery | Commercial, Medicaid | 6 | Original policy ↗ |
| Plantar Fasciitis Treatments | 338 · Commercial, Medicaid | 37 | Original policy ↗ |
| Platelet-Rich Plasma PRP | Commercial | 4 | Original policy ↗ |
| Podiatric Q Modifiers | Commercial, Medicaid | — | Original policy ↗ |
| Podiatric Q Modifiers | Medicaid · AZ, IA, ID, MI, NE, OH, SC, TX, UT, WI | — | Original policy ↗ |
| Posterior Nasal Nerve Ablation | Commercial, Medicaid | 3 | Original policy ↗ |
| Posterior Nasal Nerve Ablation MEDICARE | | 3 | Original policy ↗ |
| Power Enhanced, Robotically Assisted, and Microprocessor Upper and Lower Extremity Orthoses | Commercial, Medicaid | 6 | Original policy ↗ |
| Power Enhanced, Robotically Assisted, and Microprocessor Upper and Lower Extremity Orthoses: MEDICARE | 350b · Effective Apr 15, 2026 | 6 | Original policy ↗ |
| Powered Exoskeleton for Ambulation in Patients with Lower Limb Disabilities (ReWalk) | 244 · Commercial, Medicaid | 2 | Original policy ↗ |
| Powered Exoskeleton for Ambulation in Patients with Lower Limb Disabilities MEDICARE | | 2 | Original policy ↗ |
| Pre-Transplant and Transplant Evaluations | Commercial, Medicaid | — | Original policy ↗ |
| Prescription Digital Therapeutics | 412 · Effective Jun 10, 2026 · Commercial, Medicaid | 20 | Original policy ↗ |
| Prescription Digital Therapeutics | 412b · Medicaid | 20 | Original policy ↗ |
| Prialt (ziconotide intrathecal infusion) | Commercial, Medicaid | 1 | Original policy ↗ |
| Prostatic Urethral Lift or UroLift for Benign Prostatic Hyperplasia BPH | Commercial | 4 | Original policy ↗ |
