Wellcare policies

Search Wellcare'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.

319 public policies Substrate tracks for Wellcare, by title.

Wellcare policies
PolicyDetailsCodesSource
Air Ambulance: CP.MP.175CP.MP.175 · Medicaid · HI6Original policy ↗
Air Ambulance: CP.MP.175CP.MP.175 · Medicaid · KY6Original policy ↗
Air Ambulance: CP.MP.175CP.MP.175 · Medicaid · NJ6Original policy ↗
Allergy Testing and TherapyCP.MP.100 · Medicaid · HI43Original policy ↗
Allergy Testing and TherapyCP.MP.100 · Medicaid · NJ43Original policy ↗
Allogeneic Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia: CP.MP.108CP.MP.108 · Medicaid · KY3Original policy ↗
Allogeneic Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia: CP.MP.108CP.MP.108 · Medicaid · NJ3Original policy ↗
Allogeneic Hematopoietic Cell Transplants: CP.MP.108CP.MP.108 · Medicaid · HI3Original policy ↗
Allogeneic Hematopoietic Progenitor Cell Therapy: CP.MP.249CP.MP.249 · Medicaid · NJ2Original policy ↗
Applied Behavior Analysis: CP.BH.104CP.BH.104 · Medicaid · KY18Original policy ↗
Applied Behavioral Analysis Documentation Requirements: CP.BH.105CP.BH.105 · Medicaid · KY18Original policy ↗
Applied Behavioral Analysis Documentation Requirements: CP.BH.105CP.BH.105 · Medicaid · NJ18Original policy ↗
Applied Behavioral Analysis: CP.BH.104CP.BH.104 · Medicaid · NJ18Original policy ↗
Aquatic Therapy: HI.CP.MP.500HI.CP.MP.500 · Medicaid · HI1Original policy ↗
Articular Cartilage Defect Repairs: CP.MP.26CP.MP.26 · Medicaid · KY10Original policy ↗
Attention Deficit Hyperactivity Disorder Assessment and Treatment: CP.BH.124CP.BH.124 · Medicaid · KY168Original policy ↗
Attention Deficit Hyperactivity Disorder Assessment and Treatment: CP.BH.124CP.BH.124 · Medicaid · NJ168Original policy ↗
Bariatric SurgeryCP.MP.37 · Medicaid · NJ32Original policy ↗
Behavioral Health Treatment Documentation Requirements: CP.BH.500CP.BH.500 · Medicaid · HI—Original policy ↗
Behavioral Health Treatment Documentation Requirements: CP.BH.500CP.BH.500 · Medicaid · KY—Original policy ↗
Behavioral Health Treatment Documentation Requirements: CP.BH.500CP.BH.500 · Medicaid · NJ—Original policy ↗
Biofeedback : CP.MP.168CP.MP.168 · Medicaid · NJ4Original policy ↗
Biofeedback for Behavioral Health DisordersCP.BH.300 · Medicaid · KY3Original policy ↗
Biofeedback: CP.MP.168CP.MP.168 · Medicaid · HI4Original policy ↗
Biofeedback: CP.MP.168CP.MP.168 · Medicaid · KY4Original policy ↗
Bone Anchored Hearing Aid: CP.MP.93CP.MP.93 · Medicaid · NJ18Original policy ↗
Bone-Anchored Hearing Aid: CP.MP.93CP.MP.93 · Medicaid · HI18Original policy ↗
Bronchial Thermoplasty: CP.MP.110CP.MP.110 · Medicaid · HI2Original policy ↗
Bronchial Thermoplasty: CP.MP.110CP.MP.110 · Medicaid · KY2Original policy ↗
Bronchial Thermoplasty: CP.MP.110CP.MP.110 · Medicaid · NJ2Original policy ↗
Burn SurgeryCP.MP.186 · Medicaid · KY22Original policy ↗
Burn Surgery: CP.MP.186CP.MP.186 · Medicaid · HI22Original policy ↗
Burn Surgery: CP.MP.186CP.MP.186 · Medicaid · NJ8Original policy ↗
Caudal or Interlaminar Epidural Steroid Injections: CP.MP.164CP.MP.164 · Medicaid · HI8Original policy ↗
Caudal or Interlaminar Epidural Steroid Injections: CP.MP.164CP.MP.164 · Medicaid · NJ8Original policy ↗
Clinical Policy: Bariatric SurgeryCP.MP.37 · Medicaid · HI38Original policy ↗
Clinical Policy: Biofeedback for Behavioral Health DisordersCP.BH.300 · Medicaid · NJ3Original policy ↗
Clinical Policy: DiscographyCP.MP.115 · Medicaid · NJ5Original policy ↗
Clinical Policy: Fecal Incontinence TreatmentsCP.MP.137 · Medicaid · HI31Original policy ↗
Clinical Policy: Fecal Incontinence TreatmentsCP.MP.137 · Medicaid · NJ31Original policy ↗
Clinical Policy: Gastrointestinal Pathogen Nucleic Acid Detection Panel TestingCP.MP.209 · Medicaid · NJ4Original policy ↗
Clinical Policy: Holter MonitorsCP.MP.113 · Medicaid · HI5Original policy ↗
Clinical Policy: Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins and Other Symptomatic Venous DisordersCP.MP.146 · Medicaid · NJ6Original policy ↗
Clinical Policy: Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve StimulationCP.MP.117 · Medicaid · NJ26Original policy ↗
Clinical Policy: Urodynamic TestingCP.MP.98 · Medicaid · KY15Original policy ↗
Clinical Trials: CP.MP.94CP.MP.94 · Medicaid · HI—Original policy ↗
Clinical Trials: CP.MP.94CP.MP.94 · Medicaid · KY—Original policy ↗
Clinical Trials: CP.MP.94CP.MP.94 · Medicaid · NJ—Original policy ↗
Concert Genetic Testing Oncology: Algorithmic Assays: V2.2025Medicaid · KY102Original policy ↗
Concert Genetic Testing Oncology: Algorithmic Assays: V2.2025Medicaid · NJ102Original 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.