Wellcare policies, page 6

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
Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention: CP.MP.147CP.MP.147 · Medicaid · NJ1Original policy ↗
Percutaneous Left Atrial Appendage Closure for Stroke Prevention: CP.MP.147CP.MP.147 · Medicaid · HI1Original policy ↗
Phototherapy for Neonatal HyperbilirubinemiaCP.MP.150 · Medicaid · NJ2Original policy ↗
Phototherapy for Neonatal Hyperbilirubinemia: CP.MP.150CP.MP.150 · Medicaid · HI2Original policy ↗
Physical, Occupational, and Speech Therapy ServicesCP.MP.49 · Medicaid · NJ—Original policy ↗
Physical, Occupational, and Speech Therapy Services: CP.MP.49CP.MP.49 · Medicaid · HI—Original policy ↗
Physical, Occupational, and Speech Therapy Services: CP.MP.49CP.MP.49 · Medicaid · KY—Original policy ↗
Polymerase Chain Reaction Respiratory Viral Panel TestingCP.MP.181 · Medicaid · NJ13Original policy ↗
Polymerase Chain Reaction Respiratory Viral Panel Testing: CP.MP.181CP.MP.181 · Medicaid · KY10Original policy ↗
Posterior Tibial Nerve Stimulation for Voiding DysfunctionCP.MP.133 · Medicaid · HI5Original policy ↗
Posterior Tibial Nerve Stimulation for Voiding DysfunctionCP.MP.133 · Medicaid · KY5Original policy ↗
Posterior Tibial Nerve Stimulation for Voiding DysfunctionCP.MP.133 · Medicaid · NJ5Original policy ↗
Private Duty Nursing: NJ.CP.MP.501NJ.CP.MP.501 · Medicaid · NJ3Original policy ↗
Proton and Neutron Beam TherapiesCP.MP.70 · Medicaid · NJ6Original policy ↗
Proton and Neutron Beam Therapies: CP.MP.70CP.MP.70 · Medicaid · KY6Original policy ↗
Psychiatric Residential Treatment Facilities (PRTF Level I and II): KY.CP.BH.503KY.CP.BH.503 · Medicaid · KY25Original policy ↗
Pulmonary Function Testing : CP.MP.242CP.MP.242 · Medicaid · KY20Original policy ↗
Pulmonary Function Testing: CP.MP.242CP.MP.242 · Medicaid · HI20Original policy ↗
Radiation Therapy for Skin Cancer: CP.MP.251CP.MP.251 · Medicaid · NJ29Original policy ↗
Repair of Nasal Valve Compromise: CP.MP.210CP.MP.210 · Medicaid · HI3Original policy ↗
Repair of Nasal Valve Compromise: CP.MP.210CP.MP.210 · Medicaid · KY3Original policy ↗
Repair of Nasal Valve Compromise: CP.MP.210CP.MP.210 · Medicaid · NJ3Original policy ↗
Respite Services: HI.CP.MP.504HI.CP.MP.504 · Medicaid · HI10Original policy ↗
Respite Services: NJ.CP.MP.500NJ.CP.MP.500 · Medicaid · NJ3Original policy ↗
Sacroiliac Joint Interventions for Pain ManagementCP.MP.166 · Medicaid · HI4Original policy ↗
Sacroiliac Joint Interventions for Pain ManagementCP.MP.166 · Medicaid · NJ4Original policy ↗
Selective Dorsal Rhizotomy for Spasticity in Cerebral Palsy: CP.MP.174CP.MP.174 · Medicaid · HI2Original policy ↗
Selective Dorsal Rhizotomy for Spasticity in Cerebral Palsy: CP.MP.174CP.MP.174 · Medicaid · KY2Original policy ↗
Selective Dorsal Rhizotomy for Spasticity in Cerebral Palsy: CP.MP.174CP.MP.174 · Medicaid · NJ2Original policy ↗
Selective Nerve Root Blocks and Transforaminal Epidural Steroid Injections: CP.MP.165CP.MP.165 · Medicaid · HI4Original policy ↗
Selective Nerve Root Blocks and Transforaminal Epidural Steroid Injections: CP.MP.165CP.MP.165 · Medicaid · NJ4Original policy ↗
Skin and Soft Tissue SubstitutesCP.MP.185 · Medicaid · HI396Original policy ↗
Skin and Soft Tissue SubstitutesCP.MP.185 · Medicaid · KY396Original policy ↗
Skin and Soft Tissue SubstitutesCP.MP.185 · Medicaid · NJ396Original policy ↗
Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve StimulationCP.MP.117 · Medicaid · HI26Original policy ↗
Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve StimulationCP.MP.117 · Medicaid · KY26Original policy ↗
Stereotactic Body Radiation Therapy: CP.MP.22CP.MP.22 · Medicaid · HI15Original policy ↗
Stereotactic Body Radiation Therapy: CP.MP.22CP.MP.22 · Medicaid · KY14Original policy ↗
Stereotactic Body Radiation Therapy: CP.MP.22CP.MP.22 · Medicaid · NJ15Original policy ↗
Tandem TransplantCP.MP.162 · Medicaid · HI7Original policy ↗
Tandem TransplantCP.MP.162 · Medicaid · KY7Original policy ↗
Tandem TransplantCP.MP.162 · Medicaid · NJ7Original policy ↗
Testing for Drugs of Abuse: KY.CP.MP.50KY.CP.MP.50 · Medicaid · KY73Original policy ↗
Testing for Select Genitourinary Conditions: CP.MP.97CP.MP.97 · Medicaid · NJ18Original policy ↗
Therapeutic Utilization of Inhaled Nitric Oxide: CP.MP.87CP.MP.87 · Medicaid · HI1Original policy ↗
Therapeutic Utilization of Inhaled Nitric Oxide: CP.MP.87CP.MP.87 · Medicaid · KY1Original policy ↗
Therapeutic Utilization of Inhaled Nitric Oxide: CP.MP.87CP.MP.87 · Medicaid · NJ1Original policy ↗
Total Artificial Heart: CP.MP.127CP.MP.127 · Medicaid · HI2Original policy ↗
Total Artificial Heart: CP.MP.127CP.MP.127 · Medicaid · NJ2Original policy ↗
Total Parenteral Nutrition and Intradialytic Parenteral NutritionCP.MP.163 · Medicaid · HI9Original 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.