Wellpoint policies, page 5
Search Wellpoint'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.
422 public policies Substrate tracks for Wellpoint, by title.
| Policy | Details | Codes | Source |
|---|---|---|---|
| Medical Recalls | G-06111 · Effective May 22, 2024 · Medicaid · WV | — | Original policy ↗ |
| Medicare Advantage Quick Reference Card | Medicaid · TX | — | Original policy ↗ |
| Member Preventative Health Guidelines | Medicaid · WV | — | Original policy ↗ |
| MLTC Provider Manual | NY-WP-CD-PM-003952-25-GRP1355 · Medicaid · NY | — | Original policy ↗ |
| Modifier 22 | G-07020 · Effective Sep 6, 2024 · Medicaid · DC | — | Original policy ↗ |
| Modifier 22 | G-07020 · Effective Sep 6, 2024 · Medicaid · GA, MD, WA | — | Original policy ↗ |
| Modifier 22 | G-07020 · Effective Sep 6, 2024 · AZ, IA, NJ, SC, TN, TX, WA | — | Original policy ↗ |
| Modifier 22 | G-07020 · Effective Sep 6, 2024 · Medicaid · TX | — | Original policy ↗ |
| Modifier 22 | G-07020 · Effective Sep 6, 2024 · Medicaid · TX | — | Original policy ↗ |
| Modifier 22 | G-07020 · Effective Sep 6, 2024 · Medicaid · WV | — | Original policy ↗ |
| Modifier 24 | G-06011 · Effective Jun 11, 2025 · Medicaid · DC | — | Original policy ↗ |
| Modifier 24 | G-06011 · Effective Jun 11, 2025 · Medicaid · MD | — | Original policy ↗ |
| Modifier 24 | G-06011 · Effective Jun 11, 2025 · SC, TX | — | Original policy ↗ |
| Modifier 24 | G-06011 · Effective Jun 11, 2025 · Medicaid · TX | — | Original policy ↗ |
| Modifier 24 | G-06011 · Effective Dec 27, 2022 · Medicaid · TX | — | Original policy ↗ |
| Modifier 24 | G-06011 · Effective Jun 11, 2025 · Medicaid · WV | — | Original policy ↗ |
| Modifier 26 and TC | G-15004 · Effective Oct 30, 2023 · WV | — | Original policy ↗ |
| Modifier 50 and 51: Multiple and Bilateral Surgery | G-06010 · Effective Dec 18, 2025 · Medicaid · WV | — | Original policy ↗ |
| Modifier 62 | G-06027 · Effective Mar 26, 2026 · Medicaid · DC | — | Original policy ↗ |
| Modifier 62 | G-06027 · Effective Mar 26, 2026 · Medicaid · MD | — | Original policy ↗ |
| Modifier 62 | G-06027 · Effective Mar 26, 2026 · AZ, IA, NJ, SC, TN, TX, WA | — | Original policy ↗ |
| Modifier 62 | G-06027 · Effective Mar 26, 2026 · Medicaid · TX | — | Original policy ↗ |
| Modifier 62 | G-06027 · Effective Aug 7, 2020 · Medicaid · TX | — | Original policy ↗ |
| Modifier 62 | G-06027 · Effective Mar 26, 2026 · Medicaid · WV | — | Original policy ↗ |
| Modifier 63 | G-06015 · Effective Apr 1, 2023 · Medicaid · DC | — | Original policy ↗ |
| Modifier 63 | G-06015 · Effective Aug 28, 2020 · Medicaid · MD | — | Original policy ↗ |
| Modifier 63 | G-06015 · Effective Aug 28, 2020 · SC, TX | — | Original policy ↗ |
| Modifier 63 | G-06015 · Effective Nov 16, 2018 · Medicaid | — | Original policy ↗ |
| Modifier 63 | G-06015 · Effective Aug 28, 2020 · Medicaid · TX | — | Original policy ↗ |
| Modifier 63 | G-06015 · Effective Aug 28, 2020 · Medicaid · WV | — | Original policy ↗ |
| Modifier 66 | G-06039 · Effective Aug 7, 2020 · Medicaid · GA, WA | — | Original policy ↗ |
| Modifier 66 | G-06039 · Effective Aug 7, 2020 · AZ, IA, NJ, SC, TN, TX, WA | — | Original policy ↗ |
| Modifier 66 | G-06039 · Effective Aug 7, 2020 · Medicaid · TX | — | Original policy ↗ |
| Modifier 66 | G-06039 · Effective Aug 7, 2020 · Medicaid · WV | — | Original policy ↗ |
| Modifier 66: Surgical Team | G-06039 · Effective Apr 1, 2023 · Medicaid · DC | — | Original policy ↗ |
| Modifier 76 | G-06018 · Effective Jan 26, 2026 · Medicaid · DC | — | Original policy ↗ |
| Modifier 76 | G-06018 · Effective Jan 26, 2026 · Medicaid · MD | — | Original policy ↗ |
| Modifier 76 | G-06018 · Effective Jan 26, 2026 · AZ, IA, NJ, SC, TN, TX, WA, WV | — | Original policy ↗ |
| Modifier 76 | G-06018 · Effective Jan 26, 2026 · Medicaid · TX | — | Original policy ↗ |
| Modifier 76 | G-06018 · Effective Oct 1, 2017 · Medicaid · TX | — | Original policy ↗ |
| Modifier 76 | G-06018 · Effective Jan 26, 2026 · Medicaid · WV | — | Original policy ↗ |
| Modifier 77 | G-06019 · Effective Apr 1, 2023 · Medicaid · DC | — | Original policy ↗ |
| Modifier 77 | G-06019 · Effective Jan 26, 2026 · Medicaid · MD | — | Original policy ↗ |
| Modifier 77 | G-06019 · Effective Jan 26, 2026 · AZ, IA, NJ, SC, TN, TX, WA | — | Original policy ↗ |
| Modifier 77 | G-06019 · Effective Jan 26, 2026 · Medicaid | — | Original policy ↗ |
| Modifier 77 | G-06019 · Effective Oct 1, 2017 · Medicaid · TX | — | Original policy ↗ |
| Modifier 77 | G-06019 · Effective Jan 26, 2026 · Medicaid · WV | — | Original policy ↗ |
| Modifier 78 | G-13001 · Effective Sep 11, 2025 · Medicaid · DC | — | Original policy ↗ |
| Modifier 78 | G-13001 · Effective Sep 11, 2025 · Medicaid · GA, MD, WA | — | Original policy ↗ |
| Modifier 78 | G-06016 · Effective Sep 11, 2025 · AZ, IA, NJ, SC, TN, TX, WA | — | Original policy ↗ |