Molina HealthCare Washington policies, page 7

Search Molina HealthCare Washington'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.

373 public policies Substrate tracks for Molina HealthCare Washington, by title.

Molina HealthCare Washington policies
PolicyDetailsCodesSource
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 ↗
Recovery Policy Variable Discount Payments for ProvidersCommercial, Medicaid—Original policy ↗
Reduced Services and Discontinued ProceduresCommercial, Medicaid4Original policy ↗
Reduced Services and Discontinued Procedures, Professional and Facility—Original policy ↗
Reimbursement Policy for Corrected ClaimsMedicaid—Original policy ↗
Remote Patient Monitoring419 · Effective Oct 8, 2025 · Commercial, Medicaid25Original policy ↗
Renal AutotransplantationCommercial, Medicaid1Original policy ↗
Repeat Procedure Modifiers 76 77Commercial2Original policy ↗
Repeat Procedure Modifiers 76 77Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI2Original policy ↗
Respiratory Pathogen Panel Testing PolicyCommercial, Medicaid6Original policy ↗
Robotically Assisted SurgeryCommercial, Medicaid1Original policy ↗
Ryoncil (remestemcel)Commercial3Original policy ↗
Scenesse (afamelanotide) Implant367 · Commercial, Medicaid1Original policy ↗
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 ↗
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 ↗
Therapy Modifier CodingCommercial, Medicaid—Original policy ↗
Therapy Modifier Coding—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 ↗

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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.