Passport by Molina Healthcare policy
Phototherapy and Laser Therapy for Dermatological Conditions KY
Phototherapy and Laser Therapy for Dermatological Conditions KY is a public Passport by Molina Healthcare policy (effective Dec 4, 2025). It lists 12 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
- Effective
- Dec 4, 2025
- Line of business
- Medicaid
- States
- KY
- Source
- www.molinahealthcare.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other Passport by Molina Healthcare policies |
|---|---|
| 96900 | Policies naming 96900 |
| 96910 | Policies naming 96910 |
| 96912 | Policies naming 96912 |
| 96913 | Policies naming 96913 |
| 96920 | Policies naming 96920 |
| 96921 | Policies naming 96921 |
| 96922 | Policies naming 96922 |
| A4633 | Policies naming A4633 |
| E0691 | Policies naming E0691 |
| E0692 | Policies naming E0692 |
| E0693 | Policies naming E0693 |
| E0694 | Policies naming E0694 |