Passport Health Plan by Molina Healthcare policies, page 8

Search Passport Health Plan 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.

379 public policies Substrate tracks for Passport Health Plan by Molina Healthcare, by title.

Passport Health Plan by Molina Healthcare policies
PolicyDetailsCodesSource
Timely Filing Reimbursement PolicyMedicaid · KY—Original policy ↗
Topical and Intralesional TherapiesCommercial, Medicaid12Original policy ↗
Topical Oxygen TherapyCommercial1Original policy ↗
Transcatheter Mitral Valve Implantation437 · Commercial, Medicaid2Original policy ↗
Treatment-Plan-Development-Payment-Policy_240417_R.ashxMedicaid · KY2Original policy ↗
Tregzi (allogeneic regulatory T cell immunotherapy with HSPC and T cells-vldq)Commercial, Medicaid5Original policy ↗
Tudriqev (vusolimogene oderparepec)486 · Effective Aug 12, 2026 · Commercial, Medicaid4Original policy ↗
Tudriqev (vusolimogene oderparepec): MEDICARE486b · Effective Aug 19, 20264Original policy ↗
Unlisted CodingCommercial, Medicaid25Original policy ↗
Unspecified Codes in an Inpatient SettingCommercial—Original policy ↗
Visudyne (verteporfin) for Ocular Photodynamic Therapy308 · Commercial, Medicaid4Original policy ↗
Vitamin D Assay TestingMedicaid · KY2Original policy ↗
Vyjuvek (beremagene geperpavec)Commercial, Medicaid1Original policy ↗
Vyjuvek (beremagene geperpavec) KYEffective Dec 4, 2025 · Medicaid · KY1Original policy ↗
Waskyra (etuvetidigene autotemcel)Commercial, Medicaid5Original policy ↗
Waskyra (etuvetidigene autotemcel) MEDICARE5Original policy ↗
Water Vapor Thermal Therapy for BPH384 · Commercial, Medicaid1Original policy ↗
Wearable Cardioverter-Defibrillator Devices451 · Commercial, Medicaid6Original policy ↗
Wheelchair-Mounted Robotic Arm Devices446 · Effective Dec 10, 2025 · Commercial, Medicaid2Original policy ↗
Whole Body MRICommercial, Medicaid2Original policy ↗
Wireless Capsule for the Evaluation of Suspected Gastric and Intestinal Motility Disorders382 · Effective Jun 10, 2026 · Commercial, Medicaid1Original policy ↗
Wireless Pulmonary Artery Pressure Monitoring (CardioMEMS) for Congestive Heart Failure393 · Commercial, Medicaid5Original policy ↗
Xenoview (Xenon MRI)Commercial2Original policy ↗
Yescarta (axicabtagene ciloleucel)Commercial, Medicaid5Original policy ↗
Zevaskyn (prademagene zamikeracel)Commercial, Medicaid1Original policy ↗
Zevaskyn (prademagene zamikeracel)Effective Aug 22, 2026 · Medicaid · KY1Original policy ↗
Zevaskyn (prademagene zamikeracel) MEDICARE1Original policy ↗
Zolgensma (onasemnogene abeparvovec)348 · Effective Jun 10, 2026 · Commercial3Original policy ↗
Zynteglo (betibeglogene autotemcel)420 · Effective Jun 10, 2026 · Commercial, Medicaid3Original 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.