Wellcare policies, page 3

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
Concert Genetic Testing: Transplant: V2.2025Medicaid · KY17Original policy ↗
Concert Genetic Testing: Transplant: V2.2025Medicaid · NJ17Original policy ↗
Cosmetic and Reconstructive Procedures: CP.MP.31CP.MP.31 · Medicaid · HI118Original policy ↗
Cosmetic and Reconstructive Procedures: CP.MP.31CP.MP.31 · Medicaid · KY118Original policy ↗
Cosmetic and Reconstructive Procedures: CP.MP.31CP.MP.31 · Medicaid · NJ118Original policy ↗
Deep Transcranial Magnetic Stimulation for Obsessive Compulsive Disorder: CP.BH.201CP.BH.201 · Medicaid · HI5Original policy ↗
Deep Transcranial Magnetic Stimulation for the Treatment of Obsessive Compulsive Disorder: CP.BH.201CP.BH.201 · Medicaid · KY5Original policy ↗
Deep Transcranial Magnetic Stimulation for the Treatment of Obsessive Compulsive Disorder: CP.BH.201CP.BH.201 · Medicaid · NJ5Original policy ↗
Diaphragmatic/Phrenic Nerve Stimulation: CP.MP.203CP.MP.203 · Medicaid · HI17Original policy ↗
Diaphragmatic/Phrenic Nerve Stimulation: CP.MP.203CP.MP.203 · Medicaid · KY17Original policy ↗
Diaphragmatic/Phrenic Nerve Stimulation: CP.MP.203CP.MP.203 · Medicaid · NJ17Original policy ↗
Digital EEG Spike AnalysisCP.MP.105 · Medicaid · HI14Original policy ↗
Disc Decompression ProceduresCP.MP.114 · Medicaid · HI12Original policy ↗
Disc Decompression ProceduresCP.MP.114 · Medicaid · NJ12Original policy ↗
Donor Lymphocyte InfusionCP.MP.101 · Medicaid · HI4Original policy ↗
Donor Lymphocyte InfusionCP.MP.101 · Medicaid · NJ4Original policy ↗
Donor Lymphocyte Infusion: CP.MP.101CP.MP.101 · Medicaid · KY4Original policy ↗
Drugs of Abuse: Definitive Testing: CP.MP.50CP.MP.50 · Medicaid · NJ79Original policy ↗
Durable Medical Equipment (DME): CP.MP.107CP.MP.107 · Medicaid · HI340Original policy ↗
Durable Medical Equipment and Orthotics and Prosthetics Guidelines: CP.MP.107CP.MP.107 · Medicaid · KY340Original policy ↗
Durable Medical Equipment and Orthotics and Prosthetics Guidelines: CP.MP.107CP.MP.107 · Medicaid · NJ340Original policy ↗
EEG in the Evaluation of HeadacheCP.MP.155 · Medicaid · HI5Original policy ↗
Electric Tumor Treating Fields (Optune): CP.MP.145CP.MP.145 · Medicaid · HI2Original policy ↗
Electric Tumor Treating Fields (Optune): CP.MP.145CP.MP.145 · Medicaid · KY2Original policy ↗
Electric Tumor Treating Fields (Optune): CP.MP.145CP.MP.145 · Medicaid · NJ2Original policy ↗
Endometrial AblationCP.MP.106 · Medicaid · KY3Original policy ↗
Endometrial Ablation: CP.MP.106CP.MP.106 · Medicaid · HI3Original policy ↗
Evoked Potential TestingCP.MP.134 · Medicaid · HI17Original policy ↗
Evoked Potential Testing: CP.MP.134CP.MP.134 · Medicaid · NJ17Original policy ↗
Experimental Technologies CP.MP.36CP.MP.36 · Medicaid · KY—Original policy ↗
Experimental Technologies: CP.MP.36CP.MP.36 · Medicaid · HI—Original policy ↗
Experimental Technologies: CP.MP.36CP.MP.36 · Medicaid · NJ—Original policy ↗
Facet Joint InterventionsCP.MP.171 · Medicaid · HI16Original policy ↗
Facet Joint InterventionsCP.MP.171 · Medicaid · NJ16Original policy ↗
Facility-based Sleep Studies for Obstructive Sleep ApneaCP.MP.248 · Medicaid · KY5Original policy ↗
Facility-based Sleep Studies for Obstructive Sleep Apnea: CP.MP.248CP.MP.248 · Medicaid · NJ5Original policy ↗
Fecal Incontinence TreatmentsCP.MP.137 · Medicaid · KY31Original policy ↗
Fertility Preservation: CP.MP.130CP.MP.130 · Medicaid · HI36Original policy ↗
Fertility Preservation: CP.MP.130CP.MP.130 · Medicaid · NJ39Original policy ↗
Fetal Surgery in Utero for Prenatally Diagnosed MalformationsCP.MP.129 · Medicaid · NJ12Original policy ↗
Fetal Surgery in Utero for Prenatally Diagnosed Malformations: CP.MP.129CP.MP.129 · Medicaid · HI11Original policy ↗
Fetal Surgery in Utero for Prenatally Diagnosed Malformations: CP.MP.129CP.MP.129 · Medicaid · KY11Original policy ↗
Functional MRI: CP.MP.43CP.MP.43 · Medicaid · KY2Original policy ↗
Gastric Electrical StimulationCP.MP.40 · Medicaid · KY17Original policy ↗
Gastric Electrical Stimulation: CP.MP.40CP.MP.40 · Medicaid · HI17Original policy ↗
Gastric Electrical Stimulation: CP.MP.40CP.MP.40 · Medicaid · NJ17Original policy ↗
Gastrointestinal Pathogen Nucleic Acid Detection Panel TestingCP.MP.209 · Medicaid · KY8Original policy ↗
Gender-Affirming Procedures: CP.MP.95CP.MP.95 · Medicaid · HI144Original policy ↗
Gender-Affirming Procedures: CP.MP.95CP.MP.95 · Medicaid · NJ144Original policy ↗
Habilitation Services: NJ.CP.MP.504NJ.CP.MP.504 · Medicaid · NJ11Original 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.