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Optimum Healthcare policies, page 2

Search Optimum Healthcare'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.

150 policies name 36416, those listing the fewest codes first. A policy that names a code may also list it as excluded.

Optimum Healthcare policies
PolicyDetailsCodesSource
INDIANA PROVIDER MANUALCommercial · IN24Original policy ↗
INDIANA PROVIDER MANUALCommercial · IN24Original policy ↗
Laboratory and Venipuncture Services - Professional and FacilityC-21010 · Effective Mar 1, 2025 · Commercial · VA24Original policy ↗
Laboratory and Venipuncture Services - Professional and FacilityC-21010 · Effective Apr 1, 2026 · Commercial · CA24Original policy ↗
Maine Provider ManualMEBCBS-CM-PM-082442-25 · Effective Jan 1, 2026 · Commercial · ME24Original policy ↗
Missouri Provider ManualMOBCBS-CM-PM-087497-25 · Effective Jan 1, 2026 · Commercial · MO24Original policy ↗
Ohio Provider ManualOHBCBS-CM-PM-082438-25 · Effective Sep 1, 2025 · Commercial · OH24Original policy ↗
Ohio Provider ManualOHBCBS-CM-PM-082438-25 · Effective Jan 1, 2026 · Commercial · OH24Original policy ↗
OHIO PROVIDER MANUALEffective Jul 1, 2019 · Commercial · OH24Original policy ↗
OHIO PROVIDER MANUALEffective Aug 1, 2020 · Commercial · OH24Original policy ↗
Wisconsin Provider ManualWIBCBS-CM-PM-082441-25 · Effective Sep 1, 2025 · Commercial · WI24Original policy ↗
Wisconsin Provider ManualWIBCBS-CM-PM-082441-25 · Effective Jan 1, 2026 · Commercial · WI24Original policy ↗
Anthem Blue Cross and Blue Shield New Hampshire Provider ManualEffective Jul 1, 2021 · Commercial · NH25Original policy ↗
Anthem Blue Cross and Blue Shield New Hampshire Provider ManualEffective Oct 1, 2021 · Commercial · NH25Original policy ↗
New Hampshire Provider ManualEffective Jul 1, 2022 · Commercial · NH25Original policy ↗
NEW HAMPSHIRE PROVIDER MANUALEffective Jul 1, 2019 · Commercial · NH25Original policy ↗
NEW HAMPSHIRE PROVIDER MANUALEffective Oct 1, 2019 · Commercial · NH25Original policy ↗
NEW HAMPSHIRE PROVIDER MANUALEffective Jan 1, 2021 · Commercial · NH25Original policy ↗
NEW HAMPSHIRE PROVIDER MANUALEffective Jul 1, 2020 · Commercial · NH25Original policy ↗
Anthem Blue Cross and Blue Shield Connecticut Provider ManualEffective Jul 1, 2022 · Commercial · CT27Original policy ↗
Georgia Facility and Professional Provider ManualEffective Oct 1, 2022 · Commercial · GA27Original policy ↗
Georgia Facility and Professional Provider ManualGABCBS-CM-PM-063065-24 · Effective Jan 1, 2025 · Commercial · GA30Original policy ↗
Georgia Facility and Professional Provider ManualGABCBS-CM-PM-091749-25 · Effective Jan 1, 2026 · Commercial · GA30Original policy ↗
Georgia Facility and Professional Provider ManualEffective Oct 1, 2023 · Commercial · GA30Original policy ↗
Georgia Facility and Professional Provider ManualEffective Nov 1, 2023 · Commercial · GA30Original policy ↗
Georgia Facility and Professional Provider ManualEffective Jan 1, 2024 · Commercial · GA30Original policy ↗
Georgia Facility and Professional Provider ManualEffective Aug 1, 2021 · Commercial · GA30Original policy ↗
2026 Kentucky Commercial Provider ManualKY-BCBS-CM-PM-010987-26-S3103 · Effective Sep 1, 2026 · Commercial · KY32Original policy ↗
Anthem Blue Cross and Blue Shield Kentucky Provider ManualKYBCBS-CM-PM-061904-24 v1a.070124 · Effective Oct 1, 2024 · Commercial · KY32Original policy ↗
Anthem Blue Cross and Blue Shield Kentucky Provider ManualEffective Oct 1, 2022 · Commercial · KY32Original policy ↗
Anthem Blue Cross and Blue Shield Kentucky Provider Manualv2.031124 · Effective Oct 1, 2023 · Commercial · KY32Original policy ↗
Anthem Blue Cross and Blue Shield Kentucky Provider ManualEffective Oct 1, 2021 · Commercial · KY32Original policy ↗
Anthem Blue Cross and Blue Shield Kentucky Provider ManualKYBCBS-CM-PM-061904-24 v2b 080124 · Effective Nov 1, 2024 · Commercial · KY32Original policy ↗
Anthem Blue Cross and Blue Shield Kentucky Provider ManualEffective Aug 1, 2021 · Commercial · KY32Original policy ↗
Kentucky Provider ManualKYBCBS-CM-PM-086208-25 · Effective Nov 1, 2025 · Commercial · KY32Original policy ↗
Kentucky Provider ManualKYBCBS-CM-PM-086208-25 · Effective Jan 1, 2026 · Commercial · KY32Original policy ↗
KENTUCKY PROVIDER MANUALEffective Jan 1, 2021 · Commercial · KY32Original policy ↗
KENTUCKY PROVIDER MANUALEffective Sep 1, 2020 · Commercial · KY32Original policy ↗
KENTUCKY PROVIDER MANUALEffective Nov 1, 2019 · Commercial · KY32Original policy ↗
Laboratory and Venipuncture Services – Professional and FacilityC-21010 · Effective Aug 6, 2024 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI32Original policy ↗
Georgia Facility and Professional Provider Manual (For Commercial Products)Commercial · GA45Original policy ↗
Georgia Facility and Professional Provider Manual (For Commercial Products)Effective Jan 1, 2021 · Commercial · GA45Original policy ↗
Georgia Facility and Professional Provider Manual (For Commercial Products)Commercial · GA46Original policy ↗
2025 Anthem Blue Cross PPO Provider Manual v1CABC-CM-PM-091236-25 · Effective Jan 1, 2026 · Commercial · CA47Original policy ↗
2025 Anthem Blue Cross PPO Provider Manual v2CABC-CM-PM-091236-25 · Effective Jun 1, 2026 · Commercial, Medicaid · CA47Original policy ↗
California Facility and Professional Provider ManualCABC-CM-PM-066114-24 · Effective Jan 1, 2025 · Commercial, Medicaid · CA47Original policy ↗
Anthem Blue Cross California Facility and Professional Provider ManualEffective Dec 15, 2021 · Commercial, Medicaid · CA54Original policy ↗
California Facility and Professional Provider ManualEffective Nov 1, 2020 · Commercial, Medicaid · CA54Original policy ↗
California Facility and Professional Provider ManualEffective Aug 1, 2023 · Commercial, Medicaid · CA55Original policy ↗
California Facility and Professional Provider ManualEffective Aug 1, 2022 · Commercial, Medicaid · CA55Original 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.

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