Wellpoint policies, page 8

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.

Wellpoint policies
PolicyDetailsCodesSource
Preventive Medicine and Sick Visits on the Same DayG-05016 · Effective Jul 1, 2026 · Medicaid · GA, MD, WA—Original policy ↗
Preventive Medicine and Sick Visits on the Same DayG-05016 · Effective Apr 1, 2026 · AZ, IA, NJ, SC, TN, TX, WA—Original policy ↗
Preventive Medicine and Sick Visits on the Same DayG-05016 · Effective Jul 1, 2026 · Medicaid · TX—Original policy ↗
Preventive Medicine and Sick Visits on the Same DayG-05016 · Effective Aug 1, 2026 · Medicaid · WV—Original policy ↗
Professional Anesthesia ServicesG-07018 · Effective Nov 14, 2025 · Medicaid · DC—Original policy ↗
Professional Anesthesia ServicesG-07018 · Effective Nov 14, 2025 · Medicaid · MD2Original policy ↗
Professional Anesthesia ServicesG-07018 · Effective Nov 14, 2025 · AZ, IA, NJ, SC, TN, TX, WA—Original policy ↗
Professional Anesthesia ServicesG-07018 · Effective Nov 14, 2025 · Medicaid · TX2Original policy ↗
Professional Anesthesia ServicesG-07018 · Effective Nov 6, 2020 · Medicaid · TX2Original policy ↗
Professional Anesthesia ServicesG-07018 · Effective Nov 14, 2025 · Medicaid · WV—Original policy ↗
Proof of Timely FilingG-06133 · Effective Oct 23, 2025 · Medicaid · DC—Original policy ↗
Proof of Timely FilingG-06133 · Effective Oct 23, 2025 · Medicaid · MD—Original policy ↗
Proof of Timely FilingG-06133 · Effective Oct 23, 2025 · AZ, IA, NJ, SC, TN, TX, WA—Original policy ↗
Proof of Timely FilingG-06133 · Effective Oct 23, 2025 · Medicaid · TX—Original policy ↗
Proof of Timely FilingG-06133 · Effective Nov 19, 2021 · Medicaid · TX—Original policy ↗
Proof of Timely FilingG-06133 · Effective Oct 23, 2025 · Medicaid · WV—Original policy ↗
Prosthetic and Orthotic DevicesG-06084 · Effective Apr 1, 2023 · Medicaid · DC—Original policy ↗
Prosthetic and Orthotic DevicesG-06084 · Effective Jan 1, 2025 · Medicaid · MD—Original policy ↗
Prosthetic and Orthotic DevicesG-06084 · Effective Oct 14, 2024 · AZ, IA, NJ, SC, TN, TX, WA—Original policy ↗
Prosthetic and Orthotic DevicesG-06084 · Effective Oct 14, 2024 · Medicaid · TX—Original policy ↗
Prosthetics and Orthotic DevicesG-06084 · Effective Oct 14, 2024 · Medicaid · WV—Original policy ↗
Provider Digital Engagement SupplementMedicaid · MD—Original policy ↗
Provider ManualMedicaid · DC34Original policy ↗
Provider ManualMULTI-WP-CR-PM-008701-26-GRP2620 · Effective Apr 1, 2026 · Medicaid · SC, TX, WV4Original policy ↗
Provider Preventable ConditionsG-20003 · Effective Mar 22, 2023 · Medicaid · DC—Original policy ↗
Provider Preventable ConditionsG-20003 · Effective Mar 22, 2023 · Medicaid · GA, MD, WA—Original policy ↗
Provider Preventable ConditionsG-20003 · Effective Mar 22, 2023 · AZ, IA, NJ, SC, TN, TX, WA—Original policy ↗
Provider Preventable ConditionsG-20003 · Effective Mar 22, 2023 · Medicaid · TX—Original policy ↗
Provider Preventable ConditionsG-20003 · Effective Mar 22, 2023 · Medicaid · WV—Original policy ↗
Provider Quick Reference CardMedicaid · DC—Original policy ↗
Reimbursement for Items Under WarrantyG-06112 · Effective Sep 11, 2025 · Medicaid · DC—Original policy ↗
Reimbursement for Items Under WarrantyG-06112 · Effective Sep 11, 2025 · Medicaid · MD—Original policy ↗
Reimbursement for items under WarrantyG-06112 · Effective Apr 6, 2023 · AZ, IA, NJ, SC, TN, TX, WA—Original policy ↗
Reimbursement for items under WarrantyG-06112 · Effective Sep 11, 2025 · Medicaid · TX—Original policy ↗
Reimbursement for Reduced and Discontinued ServicesG-10033 · Effective Nov 18, 2021 · Medicaid · WV—Original policy ↗
Reimbursements of Items Under WarrantyG-06112 · Effective Sep 11, 2025 · Medicaid · WV—Original policy ↗
Sanctioned and Opt-Out ProvidersG-10002 · Effective Dec 30, 2024 · Medicaid · DC—Original policy ↗
Sanctioned and Opt-Out ProvidersG-10002 · Effective Dec 30, 2024 · Medicaid · MD—Original policy ↗
Sanctioned and Opt-Out ProvidersG-10002 · Effective Dec 20, 2024 · AZ, IA, NJ, SC, TN, TX, WA—Original policy ↗
Sanctioned and Opt-Out ProvidersG-10002 · Effective Dec 30, 2024 · Medicaid · TX—Original policy ↗
Sanctioned ProvidersG-10002 · Effective Dec 30, 2024 · Medicaid · WV—Original policy ↗
Scope of PracticeG-12004 · Effective Apr 29, 2022 · Medicaid · WV—Original policy ↗
Simplify processes and enhance care with our Texas Provider Protection PlanMedicaid · TX—Original policy ↗
Split Care Surgical ModifiersG-11005 · Effective Aug 18, 2025 · Medicaid · WV—Original policy ↗
Split-Care Surgical ModifiersG-11005 · Effective Aug 18, 2025 · Medicaid · DC—Original policy ↗
Split-Care Surgical ModifiersG-11005 · Effective Aug 18, 2025 · Medicaid · GA, MD, WA—Original policy ↗
Split-Care Surgical ModifiersG-11005 · Effective Aug 18, 2025 · AZ, IA, NJ, NM, SC, TN, TX, WA—Original policy ↗
Split-Care Surgical ModifiersG-11005 · Effective Aug 18, 2025 · Medicaid · TX—Original policy ↗
STAR+PLUS MMP (Medicare-Medicaid Plan) Provider ManualMedicaid · TX5Original policy ↗
SterilizationG-06163 · Effective Jul 17, 2024 · Medicaid · DC—Original 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.