Molina Healthcare of Kentucky policies, page 6

Search Molina Healthcare of Kentucky'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.

379 public policies Substrate tracks for Molina Healthcare of Kentucky, by title.

Molina Healthcare of Kentucky policies
PolicyDetailsCodesSource
Percutaneous Image-Guided Lumbar Decompression (PILD) for Lumbar Spinal StenosisCommercial4Original policy ↗
Percutaneous Ventricular Assist Devices132 · Commercial, Medicaid6Original policy ↗
Perirectal Spacer for Prostate Radiotherapy425 · Commercial1Original policy ↗
Peroral Endoscopic Myotomy for Esophageal Achalasia385 · Commercial, Medicaid2Original policy ↗
Phototherapy and Laser Therapy for Dermatological Conditions KYEffective Dec 4, 2025 · Medicaid · KY12Original policy ↗
Phototherapy, Photochemotherapy, and Laser Therapy for Dermatological Conditions292 · Commercial, Medicaid12Original policy ↗
Physician Office Laboratory TestingCommercial, Medicaid60Original policy ↗
Physician Office Laboratory TestingMedicaid211Original policy ↗
Plantar Fasciitis SurgeryCommercial, Medicaid6Original policy ↗
Plantar Fasciitis Treatments338 · Commercial, Medicaid37Original policy ↗
Platelet-Rich Plasma PRPCommercial4Original policy ↗
Pluvicto KY Effective Date December 4, 2025Effective Dec 4, 2025 · Medicaid · KY3Original policy ↗
Podiatric Q ModifiersCommercial, Medicaid—Original policy ↗
Posterior Nasal Nerve AblationCommercial, Medicaid3Original policy ↗
Posterior Nasal Nerve Ablation MEDICARE3Original policy ↗
Power Enhanced, Robotically Assisted, and Microprocessor Upper and Lower Extremity OrthosesCommercial, Medicaid6Original policy ↗
Power Enhanced, Robotically Assisted, and Microprocessor Upper and Lower Extremity Orthoses: MEDICARE350b · Effective Apr 15, 20266Original policy ↗
Powered Exoskeleton for Ambulation in Patients with Lower Limb Disabilities (ReWalk)244 · Commercial, Medicaid2Original policy ↗
Powered Exoskeleton for Ambulation in Patients with Lower Limb Disabilities MEDICARE2Original policy ↗
Pre-Transplant and Transplant EvaluationsCommercial, Medicaid—Original policy ↗
Pre-Transplant and Transplant Evaluations KY Effective Date August 22, 2026Effective Aug 22, 2026 · Medicaid · KY—Original policy ↗
Prescription Digital Therapeutics412 · Effective Jun 10, 2026 · Commercial, Medicaid20Original policy ↗
Prescription Digital Therapeutics412b · Medicaid20Original policy ↗
Prialt (ziconotide intrathecal infusion)Commercial, Medicaid1Original policy ↗
Prostatic Urethral Lift or UroLift for Benign Prostatic Hyperplasia BPHCommercial4Original policy ↗
Proton and Neutron Beam Radiation Therapy ServicesCommercial, Medicaid57Original policy ↗
Provenge (sipuleucel-T)Commercial, Medicaid3Original policy ↗
Psychotherapy Add On with High Level EMCommercial, Medicaid7Original policy ↗
Psychotherapy Add-On with High Level E/M PolicyEffective Aug 21, 2025 · Medicaid7Original policy ↗
PT OT Initial EvaluationsCommercial, Medicaid—Original policy ↗
PT OT ST Yearly LimitEffective Aug 19, 2025 · Commercial, Medicaid—Original policy ↗
Pulmonary Function TestingMedicaid19Original policy ↗
Radiation Therapy ServicesCommercial, Medicaid117Original policy ↗
Radiation Therapy Services KY Effective Date December 4, 2025Effective Dec 4, 2025 · Medicaid · KY144Original policy ↗
Radiation Therapy Services MEDICARE117Original policy ↗
Radioembolization (Selective Internal Radiation Therapy) for Liver Tumors181 · Effective Jun 10, 2026 · Commercial, Medicaid8Original policy ↗
Radiofrequency and Pulsed Radiofrequency Ablation for Trigger Point PainCommercial, Medicaid1Original policy ↗
Radiofrequency Nerve Ablation for Neck and Back PainCommercial, Medicaid8Original policy ↗
Radiofrequency Nerve Ablation for Neck and Back Pain Effective Date August 22, 2026Effective Aug 22, 2026 · Medicaid · KY8Original policy ↗
Radiofrequency Treatment of Nasal Airway Obstruction (e.g. VivAer) KY Effective Date February 16, 2026Effective Feb 16, 2026 · Medicaid · KY1Original policy ↗
Radiofrequency Treatment of Nasal Airway Obstruction (e.g., VivAer)Commercial, Medicaid1Original policy ↗
Radiofrequency Treatment of Nasal Airway Obstruction (e.g., VivAer) MEDICARE1Original policy ↗
Radiology Bone DensityCommercial, Medicaid2Original policy ↗
Radiology for Chest PolicyEffective Aug 20, 2025 · Commercial, Medicaid4Original policy ↗
Radiology-Bone Density (DXA)Medicaid · KY3Original policy ↗
ReadmissionCommercial—Original policy ↗
Readmission—Original policy ↗
Recovery Policy for CPT to CPT CodeCommercial, Medicaid—Original policy ↗
Recovery Policy for Diagnosis CodesCommercial—Original policy ↗
Recovery Policy for Revenue to CPT Code ReviewCommercial, Medicaid—Original policy ↗

Back to Molina Healthcare of Kentucky · Molina Healthcare of Kentucky prior authorization CPT list

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.