Passport by Molina Healthcare policies
Search Passport by Molina 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.
4 policies name L8688, those listing the fewest codes first. A policy that names a code may also list it as excluded.
| Policy | Details | Codes | Source |
|---|---|---|---|
| Gastric Electrical Stimulation | 414 · Commercial | 14 | Original policy ↗ |
| Gastric Electrical Stimulation KY Effective Date February 16, 2026 | Effective Feb 16, 2026 · Medicaid · KY | 14 | Original policy ↗ |
| Implantable Peripheral Nerve and Nerve Field Stimulators for Chronic Pain | 444 · Commercial, Medicaid | 28 | Original policy ↗ |
| Neurostimulation Treatments for Epilepsy | Commercial, Medicaid | 54 | Original policy ↗ |