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Passport Health Plan by Molina Healthcare policy

Criteria for Maxillofacial Prosthetics Policy Effective Date January 1, 2026

Criteria for Maxillofacial Prosthetics Policy Effective Date January 1, 2026 is a public Passport Health Plan by Molina Healthcare policy (effective Jan 1, 2026). It lists 11 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Passport Health Plan by Molina Healthcare
Effective
Jan 1, 2026
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.

CodeOther Passport Health Plan by Molina Healthcare policies
D5913Policies naming D5913
D5914Policies naming D5914
D5919Policies naming D5919
D5931Policies naming D5931
D5932Policies naming D5932
D5934Policies naming D5934
D5952Policies naming D5952
D5953Policies naming D5953
D5954Policies naming D5954
D5955Policies naming D5955
D5988Policies naming D5988

All Passport Health Plan by Molina Healthcare policies

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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