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Optimum Healthcare policies, page 5

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.

1,402 public policies Substrate tracks for Optimum Healthcare, by title.

Optimum Healthcare policies
PolicyDetailsCodesSource
ASC Grouper ListingCommercial · CO3,389Original policy ↗
ASC Grouper ListingCommercial · NV3,389Original policy ↗
Ask-the-Expert Town Hall Webinar InvitationCommercial · MO—Original policy ↗
Asthma Patient FlyerCommercial · CT, ME, NH—Original policy ↗
Atlantic Health Partners Vaccine Purchasing ProgramCommercial · VA—Original policy ↗
Autologous and Allogeneic Pancreatic Islet Cell TransplantationTRANS.00010 · Commercial9Original policy ↗
Automated Evacuation of Meibomian GlandMED.00103 · Commercial3Original policy ↗
Behavioral Health GuideCommercial · CA—Original policy ↗
Behavioral Health Guide – GroupsCommercial · CA—Original policy ↗
Behavioral Health Guide – IndividualsCommercial · CA—Original policy ↗
Blue High Performance Network - Frequently Asked QuestionsCommercial · CO—Original policy ↗
BlueCard Claims FilingCommercial · GA—Original policy ↗
BlueCard Claims FilingCommercial · VA—Original policy ↗
BlueCard Provider ManualEffective Jan 1, 2022 · Commercial, Medicaid · CO—Original policy ↗
BlueCard Provider ManualEffective Jan 1, 2022 · Commercial, Medicaid · NH—Original policy ↗
BlueCard Provider ManualEffective Jan 1, 2022 · Commercial, Medicaid · MO—Original policy ↗
BlueCard Provider ManualEffective Jan 1, 2022 · Commercial, Medicaid · ME—Original policy ↗
BlueCard Provider ManualEffective Jan 1, 2022 · Commercial, Medicaid · NV—Original policy ↗
BlueCard Provider ManualEffective Jan 1, 2022 · Commercial, Medicaid · CA—Original policy ↗
BlueHPN FAQCommercial · WI—Original policy ↗
BlueHPN Introduction WICommercial · WI—Original policy ↗
BlueHPN Quick Reference GuideCommercial · WI—Original policy ↗
Blues & CDHP Prior Authorization ListMULTI-BCBS-CM-054556-24 · Commercial · IN, KY, MO, OH, WI—Original policy ↗
Border County Provider ClaimsCommercial · GA—Original policy ↗
Brain Computer Interface Rehabilitation DevicesDME.00052 · Commercial1Original policy ↗
BREAST CANCER SCREENINGCommercial · CA—Original policy ↗
Breast Cancer ScreeningCommercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI—Original policy ↗
Bundled Services and Supplies - FacilityC-23001 · Effective Jun 1, 2026 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI46Original policy ↗
Bundled Services and Supplies - ProfessionalC-08003 · Effective Dec 1, 2025 · Commercial · VA341Original policy ↗
Bundled Services and Supplies - ProfessionalC-08003 · Effective Jun 24, 2026 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI390Original policy ↗
Bundled Services and Supplies - ProfessionalC-08003 · Effective Jul 1, 2026 · Commercial · CA341Original policy ↗
Bundled Services and Supplies - ProfessionalC-08003 · Effective Jan 1, 2027 · Commercial · CA360Original policy ↗
Bundled Services and Supplies – FacilityC-23001 · Effective Oct 1, 2026 · Commercial · CA39Original policy ↗
CAD Patient FlyerCommercial · CT, ME, NH—Original 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 ↗
California Facility and Professional Provider ManualCABC-CM-PM-066114-24 · Effective Jan 1, 2025 · Commercial, Medicaid · CA47Original policy ↗
California PPO Prior Authorization ListCommercial · CA3,545Original policy ↗
Capital EquipmentCommercial · NH—Original policy ↗
CAQH Solution: COB Smart FAQsCommercial · CO—Original policy ↗
CAQH Solution: COB Smart FAQsCommercial · IN, KY, MO, OH—Original policy ↗
CAQH Solution: COB Smart FAQsCommercial · NV—Original policy ↗
Carelon Medical Benefits Management Quick Reference GuideCommercial · WI—Original policy ↗
Cellular Therapy Products for Allogeneic Stem Cell TransplantationMED.00147 · Commercial2Original policy ↗
CG-ADMIN-01 Clinical Utilization Management (UM) Guideline for Pre-Payment Review Medical Necessity Determinations When No Other Clinical UM Guideline ExistsCG-ADMIN-01 · Commercial62Original policy ↗
CG-ANC-03 AcupunctureCG-ANC-03 · Commercial4Original policy ↗
CG-ANC-04 Ambulance Services: Air and WaterCG-ANC-04 · Commercial8Original policy ↗
CG-ANC-05 Ambulance Services: Ground; EmergentCG-ANC-05 · Commercial11Original policy ↗
CG-ANC-06 Ambulance Services: Ground; Non-EmergentCG-ANC-06 · Commercial8Original 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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