| Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions | 2026T0588RR · Effective Oct 1, 2026 · Commercial | 144 | Original policy ↗ |
| Molecular Pathology Policy, Professional and Facility | Commercial | 2 | Original policy ↗ |
| Molecular Pathology/Genetic Testing Reported with Unlisted Codes | MMP383.29 · Effective Sep 1, 2026 | 4 | Original policy ↗ |
| Molecular Pathology/Molecular Diagnostics/Genetic Testing | MMP210.36 · Effective Sep 1, 2026 | 108 | Original policy ↗ |
| Motorized Spinal Traction | 2026T0546X · Effective May 1, 2026 · Commercial | 1 | Original policy ↗ |
| Multiple Procedure Payment Reduction (MPPR) for Diagnostic Cardiovascular and Ophthalmology Procedures Policy, Professional | Commercial | 35 | Original policy ↗ |
| Multiple Procedure Payment Reduction (MPPR) for Medical and Surgical Services Policy, Professional | Commercial | 22 | Original policy ↗ |
| Natalizumab (Tyruko® & Tysabri®) | 2026D0026T · Effective Jul 1, 2026 · Commercial | 2 | Original policy ↗ |
| National Drug Code (NDC) Requirement Policy, Professional and Facility | Commercial | 1 | Original policy ↗ |
| Negative Pressure Wound Therapy | 2026T0594O · Effective Jun 1, 2026 · Commercial | 9 | Original policy ↗ |
| Neurologic Services and Procedures | MMP061.12 · Effective Sep 1, 2026 | 5 | Original policy ↗ |
| Neurophysiologic Testing and Monitoring | 2026T0493II · Effective Jan 1, 2026 · Commercial | 37 | Original policy ↗ |
| New Patient Visit Policy, Professional | Commercial | 35 | Original policy ↗ |
| Niktimvo™ (Axatilimab-Csfr) – Commercial and Individual Exchange Medical Benefit Drug Policy | 2026D0135C · Effective Apr 1, 2026 · Commercial | 1 | Original policy ↗ |
| Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease | MMP372.13 · Effective Sep 1, 2026 | 1 | Original policy ↗ |
| Noncontact Warming Therapy, Ultrasound Therapy, and Fluorescence Imaging for Wounds | 2026T0521AA · Effective Aug 1, 2026 · Commercial | 6 | Original policy ↗ |
| Nonphysician Health Care Codes Policy, Professional | Commercial | 24 | Original policy ↗ |
| Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy, Professional | Effective Jan 12, 2025 · Commercial | 10 | Original policy ↗ |
| Obstetrical Policy, Professional | 2026R0064B · Commercial | 57 | Original policy ↗ |
| Obstructive and Central Sleep Apnea Treatment | 2026T0525VV · Effective Oct 1, 2026 · Commercial | 48 | Original policy ↗ |
| Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) | 2026T0080UU · Effective Oct 1, 2026 · Commercial | 27 | Original policy ↗ |
| Ocrevus® (Ocrelizumab) and Ocrevus Zunovo® (Ocrelizumab and Hyaluronidase-Ocsq) | 2026D0056P · Effective Jan 1, 2026 · Commercial | 2 | Original policy ↗ |
| Ocular Photoscreening | 2026T0660F · Effective Jun 1, 2026 · Commercial | 2 | Original policy ↗ |
| Off-Label/Unproven Specialty Drug Treatment | 2026D0054N · Effective Aug 1, 2026 · Commercial | — | Original policy ↗ |
| Omnibus Codes | 2026T0535XXX · Effective Jun 1, 2026 · Commercial | 241 | Original policy ↗ |
| Omnibus Codes | MMP107.09 · Effective Jun 1, 2026 | 176 | Original policy ↗ |
| Omvoh® (Mirikizumab-Mrkz) | 2026D0129F · Effective May 1, 2026 · Commercial | 1 | Original policy ↗ |
| Oncology Medication Clinical Coverage | 2026D0030AR · Effective Sep 1, 2026 · Commercial | 62 | Original policy ↗ |
| One or More Sessions Policy, Professional | Commercial | 14 | Original policy ↗ |
| Onychomycosis Testing Policy, Professional and Facility | 2026R8011A · Effective Aug 26, 2026 · Commercial | 3 | Original policy ↗ |
| Ophthalmologic Complement Inhibitors | 2025D0118G · Effective Dec 1, 2025 · Commercial | 2 | Original policy ↗ |
| Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors | 2026D0042AQ · Effective Jul 1, 2026 · Commercial | 17 | Original policy ↗ |
| Orencia® (Abatacept) Injection for Intravenous Infusion | 2026D0039W · Effective Jun 1, 2026 · Commercial | 1 | Original policy ↗ |
| Orthognathic (Jaw) Surgery – Commercial and Individual Exchange Medical Policy | MP.013.25 · Commercial | 71 | Original policy ↗ |
| Orthopedic Procedures, Devices, and Products | MMP068.11 · Effective Sep 1, 2026 | 8 | Original policy ↗ |
| Osteopathic Manipulations (OMT) – Medicare Advantage Medical Policy | MMP227.14 · Effective Sep 1, 2026 | 5 | Original policy ↗ |
| Otarmeni™ (Lunsotogene Parvec-Cwha) – Commercial and Individual Exchange Medical Benefit Drug Policy | 2026D0143A · Effective Oct 1, 2026 · Commercial | 2 | Original policy ↗ |
| Otoacoustic Emissions Testing (for Oxford Only) | ENT 020.27 · Effective Oct 1, 2026 · Commercial | 3 | Original policy ↗ |
| Outpatient Cardiology Procedures for EviCore Arrangement (for Oxford Only) – Oxford Medical Policy | CARDIOLOGY 025.28 · Effective Sep 1, 2026 · Commercial | 33 | Original policy ↗ |
| Outpatient From-to Date Policy, Facility | Effective Jul 1, 2024 · Commercial | — | Original policy ↗ |
| Outpatient Hospital Add-on Codes Policy, Facility | Commercial | 21 | Original policy ↗ |
| Outpatient Hospital Maximum Frequency Per Day Policy, Facility | 2026R5011D · Commercial | — | Original policy ↗ |
| Outpatient Hospital Observation Policy, Facility | Commercial | 16 | Original policy ↗ |
| Outpatient Medical Visits and Trauma Activation Policy, Facility | Commercial | 19 | Original policy ↗ |
| Outpatient Radiology Procedures for EviCore Arrangement (for Oxford Only) – Oxford Medical Policy | RADIOLOGY 037.42 · Effective Sep 1, 2026 · Commercial | 171 | Original policy ↗ |
| Outpatient Rehabilitation Therapy Services Policy, Facility | Commercial | — | Original policy ↗ |
| Outpatient Surgical Procedures – Site of Service | MP.11.27 · Effective Aug 1, 2026 · Commercial | — | Original policy ↗ |
| Oxlumo® (Lumasiran) and Rivfloza® (Nedosiran) | 2026D0102K · Effective Jun 1, 2026 · Commercial | 3 | Original policy ↗ |
| Pain Management | MMP070.12 · Effective Sep 1, 2026 | 13 | Original policy ↗ |
| Panniculectomy Surgery | MP.014.28 · Effective Jul 1, 2026 · Commercial | 5 | Original policy ↗ |
