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December 2025 Provider News

Date: 12/29/25

In this issue: 

  • General Updates - Health Equity - Annual Access and Availability of Language Services Reports
  • Quality - Tacoma Pierce County Opioid Awareness Toolkit, Washington launches new tools: OUD, Depression Screening, HEDIS Behavioral Health Measure Toolkit, Controlling High Blood Pressure
  • Payment & Clinical Policy - Envolve Vision, Evolent Cardiology, Clinical Policy updates, Prior Authorization updates
  • Wellcare - Medical Clinical Policy updates 
  • Apple Health Core Connections - Updated Free National Adoption Competency Mental Health Training Initiative 
  • Training/Education - Evolent training, Health Equity 
  • Pharmacy Updates - NPI Prescriber Enforcement for Pharmacy Claims; Pharmacy Clinical Policy Updates; Evolent Medical Oncology Updates

______________________________________________________________________________________

General Updates

Health Equity- Marketplace

Standard HE 3: Access and Availability of Language Services

Element C

Language and Interpreter Resources for Ambetter Providers

This communication provides essential updates for Ambetter providers on language access services and member demographics. It includes updates on member language preferences, instructions for requesting interpreter services and translated materials, and guidance on meeting federal requirements for language access under Title VI and the Americans with Disabilities Act (ADA).

Cultural and linguistic availability of services is an important characteristic of the services Coordinated Care provides to its membership. Coordinated Care monitors, tracks, trends all available data sources and is committed to ensuring that its policies and infrastructure are attuned to the diverse needs of all members.

How to Access Interpreter Services

Language and Interpreter Services are available at no cost to Ambetter members and providers without unreasonable delay at all medical points of contact. The member has the right to file a complaint or grievance if cultural and linguistic needs are not met.

Spoken Language Interpreter

  • Contact Ambetter provider services at 1-877-687-1197, TTY 711.

Sign Language Interpreter

  • Providers should be prepared to meet the needs of the hearing impaired.
  • For in person and American Sign Language requests, contact Ambetter Provider Services as soon as possible, or at least 5 business days before the appointment. All providers (Medical, Behavioral, Pharmacy, etc.) can request language services by calling our Provider Customer Contact Center at: 1-877-687-1197 (TTY 711).

To request translation assistance and alternate formats of documents

Language assistance services, auxiliary aids and services, larger font, written and oral translation, and other alternative formats are available to members at no cost.

The health plan fulfills these requests including, but not limited to, audio format in original language of text, interpreter recording in member’s primary and/or preferred language, an interpreter may read the material to the member, or materials in hard copy braille format.

Language Services include

  • Telephonic services
  • Oral translation (reading of English material in a members preferred language)
  • In-person non-English interpretation
  • American Sign language
  • Auxiliary aids including alternate formats such as large print and braille
  • Written translations for materials that are critical for obtaining health insurance coverage and access to health care services in non-English prevalent languages
    • Information is deemed to be critical for obtaining health insurance coverage or access to health care services if the material is required by law or regulation to provide the document to an individual.

Restrictions Related to Interpretation or Facilitation of Communication:

  • Providers may not request or require an individual with limited English proficiency to provide their own interpreter.
  • Providers may not rely on staff other than qualified bilingual/multilingual staff to communicate directly with individuals with limited English proficiency.
  • Providers may not use an accompanying adult or minor child to interpret or facilitate communication.

Exceptions to these expectations include:

  • In an emergency involving an imminent threat to the safety or welfare of an individual or the public where there is no qualified interpreter for the individual with limited English proficiency immediately available.
  • Accompanying adults (minors are excluded) where the individual with limited English proficiency specifically requests that the accompanying adult interpret or facilitate communication, the accompanying adult agrees to provide such assistance, and reliance on that adult for such assistance is appropriate under the circumstances for minimal needs.

Providers are encouraged to document in the member’s medical record any member denial of professional interpreters and the circumstances that resulted in the use of a minor or accompanying adult as an interpreter.

Common Methods to Ensure Equal Communication and Access to Information:

  1. Provisions for intake forms to be completed by persons who are blind or with a low visual disability with the same confidentiality afforded other members:
    • Use of large print forms, electronic or online web-based forms, or in-person staff assistance in a private location.
  2. Provision for a presence of sign language interpreters to enable full communication with deaf or hard of hearing members who use sign language.
  3. Provision for making auditory information (E.G., automated messages) available via alternative means:
    • Written communication or secure web-based methods may be used as possible substitutes.
  4. Provision for communicating with deaf or hard of hearing members by telephone:
    • Use of telephone relay services (TRS), video relay services (VRS), a TDD, or use of secure electronic means.

Free Provider Training

Available Now: Culturally Appropriate Care & Health Equity

Objectives:

  • Explores how culturally appropriate care can improve patient outcomes, safety, and experiences in healthcare.
  • Examines the impact of unconscious bias on health outcomes and how it intersects with culturally appropriate care and health equity.
  • Course offers practical strategies to promote inclusive and equitable care.
  • Credit:
    • ACPE 1.00 Credit (1 hour)
    • AMA PRA Category 1 Credit(s)™ 1.00 Credit (1 hour)
    • ANCC 1.00 Credit (1 hour)
    • CDR 1.00 Credit (1 hour)
    • CCMC 1.00 Credit (1 hour)

 

Request a one-on-one session for additional support

To attend an upcoming New Provider Orientation or to request a one-on-one session online or in-person, visit the Coordinated Care Corporation Provider Events page for more information.

https://www.coordinatedcarehealth.com/providers/provider-events.html

Provider & Billing Manual

To access the 2025 Provider & Billing Manual visit the Provider Resources page and click on the link to the 2025 Provider & Billing Manual.

Washington State Language Demographics

In 2020, 79.2% of Washington residents reported English as their preferred language, and 8.6% prefer Spanish, according to U.S. Census data.

The threshold languages for Washington below are provided by the Resource for Entities Covered by Section 1557 of the Affordable Care Act Estimates of at Least the Top 15 Languages Spoken by Individuals with Limited English Proficiency for the 50 States, the District of Columbia, and the U.S. Territories.

Top 15 threshold languages for Washington

Rank

Language

Estimate

1

Spanish

232,748

2

Chinese

42,812

3

Vietnamese

38,432

4

Korean

27,088

5

Russian

25,421

6

Tagalog

19,128

7

Ukrainian

12,555

8

Mon-Khmer, Cambodian

9,046

9

Japanese

9,016

10

Amharic

7,590

11

Cushite

6,965

12

Arabic

6,417

13

Panjabi

6,145

14

German

3,863

15

Laotian

3,712

Source: Office for Civil Rights (OCR), Estimates of Limited English Proficiency (LEP) Populations by State used to determine Washington State’s threshold languages for Section 1557 compliance.

Coordinated Care Corporation Member Language Demographics

Coordinated Care at a minimum conducts a language assessment on an annual basis to determine the current population language within the service area.

Coordinated Care members speak more than 15 languages. We review the following data on a regular basis to determine the needs of our current members, future members, and the community. In 2024, 88.15% of Coordinated Care Corporation Marketplace members reported English as their preferred language, 3.66% preferred Chinese, and 2.66% preferred Spanish.

2024 Member Language Demographics

Data based on Coordinated Care’s 2024 annual language assessment conducted in accordance with NCQA requirements.

Top 10 Languages Reported by Membership

Membership (2024)

# of Members by Language

% of total membership

English

76,284

88.19%

Chinese

3,154

3.65%

Spanish

2,289

2.65%

Vietnamese

1,827

2.11%

Russian

954

1.10%

Korean

416

0.48%

Ukrainian

308

0.36%

Panjabi

203

0.23%

Portuguese

117

0.14%

Persian

93

0.11%

2024 Top 10 Interpreter Requests by Language and Request Type

Language Request

Phone Requests 2024

Face-to-Face Requests 2024

f

%

f

%

SPANISH

1,003

24.17%

0

33.3%

Russian

744

17.93%

0

0.0%

Mandarin

737

17.76%

0

0.0%

Vietnamese

447

10.77%

0

0.0%

Korean

200

4.82%

2

0.0%

Ukrainian

138

3.33%

0

0.0%

Cantonese

99

2.39%

0

0.0%

Punjabi

96

2.31%

0

0.0%

Arabic

78

1.88%

0

0.0%

Farsi (Persian)

77

1.86%

0

0.0%

Total Requests

4,150

 

8

 

2024 Summary of Requests for Alternative Formats

Alternate Forms

# of Requests (2024)

% of Total (2024)

LARGE PRINT ENGLISH

0

0

SIGN LANGUAGES

2

0.05%

BRAILLE (ENGLISH)

1

.74%

Best Practices Gathered from Providers

  • Documenting a member’s refusal of professional interpreter services and noting any use of a minor or accompanying adult is a best practice supported by healthcare providers to ensure cultural preferences are respected and future visits are appropriately informed.
  • If a member chooses to use a family member or friend as an interpreter, it is recommended to offer a telephonic interpreter concurrently to help ensure the accuracy and completeness of the interpretation.

Contact Your Provider Engagement Team for Support

Find out how language resources can be used to strengthen your relationship with your patients by contacting your Provider Engagement Administrator. For a list of provider engagement representatives by region, visit us here or call Customer Contact Center at 1-877-687-1197 so we can triage your call appropriately.

Providers are encouraged to review their interpreter service usage and ensure member language preferences are accurately documented. Updating this information helps improve care coordination and supports compliance with NCQA Health Equity standards.

To learn more about the language resources, visit the health equity resources page for providers on the Coordinated Care website. 

To view language preferences of your members, visit the Provider Portal at coordinatedcarehealth.com/providers.

About the Americans with Disabilities Act

Disability is any substantial limitation of one or more of a person’s daily life activities and may be present from birth or may occur during a person’s lifetime. Any individual meeting any of these conditions is an individual with a disability for purposes of coverage under the Americans with Disabilities Act.  

To meet Title VI of the Civil Rights Act of 1964 and Americans with Disabilities Act (ADA) health care providers are required to assure language access.

Programmatic access to healthcare means that policies and practices that are part of the delivery of healthcare do not hinder the ability of members with disabilities to receive the same quality of care as other persons.

In accordance with Title VI of the Civil Rights Act, Prohibition against national Origin Discriminations, the President’s Executive Order 131166, section 1557 of the Patient Protection and Affordable Care Act, The Health Plan and its providers must make language assistance available to persons with Limited English Proficiency (LEP) at all points of contact during all hours of operation.

To be removed from these fax notices or to request to be added to our email list for these notices, please email: CoordinatedCareProvider@centene.com.

Health Equity- Medicaid

Standard HE 3: Access and Availability of Language Services

Element C

Language and Interpreter Resources for Medicaid Providers

This communication provides essential updates for Medicaid providers on language access services and member demographics. It includes updates on member language preferences, instructions for requesting interpreter services and translated materials, and guidance on meeting federal requirements for language access under Title VI and the Americans with Disabilities Act (ADA).

Cultural and linguistic availability of services is an important characteristic of the services Coordinated Care provides to its membership. Coordinated Care monitors, tracks, trends all available data sources and is committed to ensuring that its policies and infrastructure are attuned to the diverse needs of all members.

How to Access Language Interpreter Services

Interpreter Services are available at no cost to members, offering access to qualified spoken and sign language interpreters for Apple Health (Medicaid) clients. Providers may schedule for in-person, video, or phone appointments through the Health Care Authority - https://hcauniversal.com/  to support clear and effective communication during care.

Video or Telephonic Interpreter Services

Sign Language Interpreter Services

  • Providers should be prepared to meet the needs of the hearing impaired.
  • Request for Sign Language Interpreters

Request sign language interpreters through the Department of Enterprise Services (DES) Office of Deaf and Hard of Hearing (ODHH) master contract utilizing their https://fortress.wa.gov/dshs/odhhapps/Interpreters/Service/Request.aspx

To request translation assistance and alternate formats of documents

Language assistance services, auxiliary aids and services, larger font, written and oral translation, and other alternative formats are available to members at no cost.

Coordinated Care fulfills these requests including, but not limited to, audio format in original language of text, interpreter recording in member’s primary and/or preferred language, an interpreter may read the material to the member, or materials in hard copy braille format.

Additional Language Resources

  • ISpeak Cards

“ISpeak” cards help your members identify their preferred language when seeking care and are available to download and print from the Washington State Coalition for Language Access website at wascla.org. In addition to the ISpeak cards, you can also find a collection of materials, as well as a “Know Your Rights” flyer for help when using interpreter services in healthcare settings. 

https://apps.wascla.org/library/folder.515983-WASCLA_Tools_for_Health_Resources

Free Provider Training

To request one-on-one training or a refresher session reach out to CoordinatedCareProvider@centene.com.

Available Now: Culturally Appropriate Care & Health Equity  

Course: Culturally Appropriate Care & Health Equity

Objectives

  • Explores how culturally appropriate care can improve patient outcomes, safety, and experiences in healthcare.
  • Examines the impact of unconscious bias on health outcomes and how it intersects with culturally appropriate care and health equity.
  • Course offers practical strategies to promote inclusive and equitable care.

Credit: 

  • ACPE 1.00 Credit (1 hour)
  • AMA PRA Category 1 Credit(s)™ 1.00 Credit (1 hour)
  • ANCC 1.00 Credit (1 hour)
  • CDR 1.00 Credit (1 hour)
  • CCMC 1.00 Credit (1 hour)

 

To access the 2025 Provider Operations Manual, visit https://www.coordinatedcarehealth.com/providers/resources/forms-resources.html   and select Apple Health (Medicaid) Manual and Guides, and select Provider Manual for Medicaid Foster Care & Apple Health Expansion (PDF).

Washington State Language Demographics

In 2020, 79.2% of Washington residents reported English as their preferred language, and 8.6% prefer Spanish, according to U.S. Census data.

The threshold languages for Washington below are provided by the Resource for Entities Covered by Section 1557 of the Affordable Care Act Estimates of at Least the Top 15 Languages Spoken by Individuals with Limited English Proficiency for the 50 States, the District of Columbia, and the U.S. Territories.

Top 15 languages threshold for Washington

Rank

Language

Estimate

1

Spanish

232,748

2

Chinese

42,812

3

Vietnamese

38,432

4

Korean

27,088

5

Russian

25,421

6

Tagalog

19,128

7

Ukrainian

12,555

8

Mon-Khmer, Cambodian

9,046

9

Japanese

9,016

10

Amharic

7,590

11

Cushite

6,965

12

Arabic

6,417

13

Panjabi

6,145

14

German

3,863

15

Laotian

3,712

Source: Office for Civil Rights (OCR), Estimates of Limited English Proficiency (LEP) Populations by State used to determine Washington State’s threshold languages for Section 1557 compliance.

Coordinated Care of Washington Member Language Demographics

Coordinated Care at a minimum conducts a language assessment on an annual basis to determine the current population language within the service area.

Coordinated Care members speak more than 15 languages. We continually looks at the following data to determine the needs of our members, future members, and the community. In 2024, 78.50% of Coordinated Care Medicaid members reported English as their preferred language and 14.60% preferred Spanish.

2024 Membership Language Demographics

Data based on Coordinated Care’s 2024 annual language assessment conducted in accordance with NCQA and HCA requirements.

Top 10 Languages Reported by Membership

Membership (2024)

# of Members by Language

% of total membership

English 

157,819

68.36%

Spanish 

29,204

12.65%

Russian 

2,139

0.93%

Vietnamese 

1,485

0.64%

Chinese 

1,410

0.61%

Ukrainian 

1,394

0.60%

Dari (Afghanistan) 

834

0.36%

Arabic 

558

0.24%

Korean

421

0.18%

Panjabi

301

0.13%

 

2024 Top 10 Interpreter Requests by Language and Request Type

Language of Request

Phone requests 2024

Face-to-Face Requests 2024

 

f

%

f

%

Spanish

8,063

60.42%

2

33.3%

Russian

1,027

7.70%

0

0.0%

Ukrainian

621

4.65%

0

0.0%

Vietnamese

490

3.67%

0

0.0%

Dari (Afghanistan)

376

2.82%

0

0.0%

Mandarin

315

2.36%

0

0.0%

Arabic

304

2.28%

0

0.0%

Amharic

170

1.27%

0

0.0%

Farsi (Persian)

123

0.92%

0

0.0%

Somali

116

0.87%

0

0.0%

Total Requests

13,161

 

2

 

2024 Summary of Requests for Alternative Formats

Alternate Forms

# of Requests (2024)

% of Total (2024)

LARGE PRINT ENGLISH

0

0

SIGN LANGUAGES

16

0.12%

BRAILLE (ENGLISH)

3

.25%

Best Practices Gathered from Providers

  • Documenting a member’s refusal of professional interpreter services and noting any use of a minor or accompanying adult is a best practice supported by healthcare providers to ensure cultural preferences are respected and future visits are appropriately informed.
  • If a member chooses to use a family member or friend as an interpreter, it is recommended to offer a telephonic interpreter concurrently to help ensure the accuracy and completeness of the interpretation.

Contact Your Provider Engagement Team for Support

You are encouraged to reach out to your dedicated Provider Engagement Administrator to find out how this information can be used to strengthen your relationship with your patients. Your Provider Engagement team is available to help you. For a list of representatives by region visit, https://www.coordinatedcarehealth.com/providers/regional-contacts.html  or call the Customer Contact Center at 1-877-644-4613 for additional support.

Providers are encouraged to review their interpreter service usage and ensure member language preferences are accurately documented. Updating this information helps improve care coordination and supports compliance with NCQA Health Equity standards.

To learn more about the language preferences of your members, visit the Provider Portal at coordinatedcarehealth.com/providers. To request a one-on-one session online or in person, visit the Coordinated Care Provider Events page for more information.

About the Americans with Disabilities Act

Disability is any substantial limitation of one or more of a person’s daily life activities and may be present from birth or may occur during a person’s lifetime. Any individual meeting any of these conditions is an individual with a disability for purposes of coverage under the Americans with Disabilities Act.  https://www.ada.gov/

To meet Title VI of the Civil Rights Act of 1964 and Americans with Disabilities Act (ADA) health care providers are required to assure language access.

Programmatic access to healthcare means that policies and practices that are part of the delivery of healthcare do not hinder the ability of members with disabilities to receive the same quality of care as other persons.

In accordance with Title VI of the Civil Rights Act, Prohibition against national Origin Discriminations, the President’s Executive Order 131166, section 1557 of the Patient Protection and Affordable Care Act, The Health Plan and its providers must make language assistance available to persons with Limited English Proficiency (LEP) at all points of contact during all hours of operation.

To be removed from these fax/email notices or to request to be added to our email list for these notices, please email: CoordinatedCareProvider@centene.com.

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Quality

Medicaid Quality

The Tacoma Pierce County Health Department has developed a free, downloadable Opioid Awareness Toolkit

“Whether you’re a youth advocate, community leader, or first responder, this toolkit provides the resources you need to help make healthier choices and save lives in your community.”

“Together, we can prevent overdose, support recovery, and create a culture of care.”

Learn more about this great resource:

https://fentanylfacts.org/opioid-awareness-toolkit/

Washington launches new tools to help medical professionals deliver life-saving medications for opioid use disorder (OUD).

The Washington State Health Care Authority (HCA) and Department of Health (DOH) just released a new resource library to help health care providers and emergency medical services (EMS) personnel build knowledge and confidence to prescribe and administer medications for opioid use disorder (MOUD).

The Importance of Depression Screening

Depression is one of the leading causes of disability across the world. 1 The earlier depression is detected, the earlier it can be treated. Research shows when collaboration occurs between primary, OB/GYN and behavioral health care to screen for depression, monitor symptoms, and provide or refer for treatment, patient outcomes improve. Perinatal depression refers to minor and major depression episodes during pregnancy and/or the first 12 months after childbirth and is a common condition that affects functional outcomes both for affected women and for their families.

Measures

  • Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS-E)
  • Depression Screening and Follow-Up for Adolescents and Adults (DSF-E)
  • Depression Remission or Response for Adolescents and Adults (DRR-E)
  • Prenatal and Postpartum Depression Screening and Follow-Up (PND-E and PDS-E)

 

HEDIS Behavioral Health Measure Toolkit

Measurement Year 2025

Unhealthy Alcohol Use Screening and Follow-Up (ASF-E)

This measure assesses the percentage of members 18 years of age and older who were screened for unhealthy alcohol use using a standardized instrument and, if screened positive, received appropriate follow-up dare.

  • Unhealthy Alcohol Use Screening: The percentage of members who had a systemic screening for unhealthy alcohol use.
  • Follow-up Care on Positive Screen: The percentage of members receiving brief counseling or other follow-up care within 60 days (2 months) of screening positive for unhealthy alcohol use.

Use of Imaging Studies for Low Back Pain

Use of Imaging Studies for Low Back Pain (LBP) - NCQA

Approximately 4.3 million ED visits in the U.S. each year are due to a low back pain-related disorder1. An estimated 75%–85% of all Americans will experience back pain at some point in their lives, and approximately 39% of American adults will experience at least one day of back pain during any three-month period2 3.

Appropriate Treatment for Upper Respiratory Infection (URI)

Appropriate Treatment for Upper Respiratory Infection (URI) - NCQA

Clinical practice guidelines do not recommend antibiotics for a majority of upper respiratory tract infections because of the viral etiology of these infections, including the common cold. A performance measure of antibiotic use for URI sheds light on the prevalence of inappropriate antibiotic prescribing in clinical practice and raises awareness of the importance of reducing inappropriate antibiotic use to combat antibiotic resistance in the community.

Use of Opioids at High Dosage (HDO)

Use of Opioids at High Dosage (HDO) - NCQA

The percentage of persons 18 years of age and older who received prescription opioids at a high dosage (average morphine milligram equivalent dose [MME] ≥90) for ≥15 days during the measurement period

Oral Health Training for Healthcare Professionals

Smiles for Life Oral Health is a comprehensive oral health curriculum for healthcare professionals and health educators. This American Dental Association endorsed curriculum is designed to enhance the role of primary care clinicians in the promotion of oral health for all age groups. This curriculum includes oral health training for all ages and offers free CME to healthcare providers. Resource: https://www.smilesforlifeoralhealth.org/

Wellcare Quality 

Controlling High Blood Pressure (CBP)- HEDIS Measure

Controlling High Blood Pressure (CBP) - NCQA

https://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality-report/controlling-high-blood-pressure-cbp/

The percentage of persons 18–85 years of age who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately controlled (<140/90 mm Hg) during the measurement period. 

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Clinical Policy Updates

Envolve Vision has announced annual updates to their policies. These changes are effective for Apple Health and Ambetter on January 1, 2026. You will find the policies on their website. You can find a link to Envolve Vision’s website on our Prior Authorization page. 

The following policies are updated as of the listed Effective Date.

Policies are posted on the Coordinated Care of Washington Policy webpage. Evolent policies are available at https://www.radmd.com/solutions  and will be accessible via the Evolent landing page found on the Coordinated Care Prior Authorization webpage effective 1/1/26.

New to List?

Policy #

Policy Title

Line of Business

Change Type

Effective Date

 

CG.CC.PP.01 

Concert Lab Payment Policy 

Apple Health, Ambetter 

Revised

1/1/2026

 

CG.CP.MP.01 

Infection Disease: Respiratory Lab Testing 

Apple Health, Ambetter 

Revised

1/1/2026

 

CG.CP.MP.02 

Infectious Disease: Multisystems Lab Testing 

Apple Health, Ambetter 

Revised

1/1/2026

 

CG.CP.MP.03 

Infectious Dz Dermatologic Lab Testing 

Apple Health, Ambetter 

Revised

1/1/2026

 

CG.CP.MP.04 

Infectious Dz Gastroenterologic Lab Testing 

Apple Health, Ambetter 

Revised

1/1/2026

 

CG.CP.MP.05 

ID Primary Care Preventive Lab Testing 

Apple Health, Ambetter 

Revised

1/1/2026

 

CG.CP.MP.06 

ID Vector-Borne and Tropical Dz Lab Testing 

Apple Health, Ambetter 

Revised

1/1/2026

 

CG.PP.551A 

Concert Genetic and Molecular Testing Payment Policy 

Apple Health, Ambetter 

Revised

1/1/2026

X

CP.MP.144

Mechanical Stretching Devices

Ambetter 

Revised

1/1/2026

X

CP.MP.145

Electric Tumor Treating Fields

Ambetter 

Revised

1/1/2026

X

CP.MP.22

Stereotactic Body Radiation Therapy

Ambetter 

Revised

1/1/2026

X

CP.MP.61

IV  Moderate Sedation, IV Deep Sedation and General Anesthesia for Dental Procedures

Ambetter 

Revised

1/1/2026

 

CP.MP.93 

Bone-anchored hearing aid 

Apple Health, Ambetter 

Revised

1/1/2026

X

CP.PP.073

Sepsis Diagnosis

Apple Health, Ambetter 

Revised

1/1/2026

X

WA.CP.BH.528

Intensive Behavioral Supportive Supervision

Apple Health

Revised

1/1/2026

X

WA.CP.BH.529

Community Behavioral Health Support: Supportive Supervision

Apple Health

Revised

1/1/2026

X

WA.CP.MP.22

Stereotactic Body Radiation Therapy

Apple Health

Revised

1/1/2026

X

WA.CP.MP.37

Bariatric Surgery

Apple Health

Revised

1/1/2026

 

WA.CP.MP.527 

Vitamin D Testing 

Apple Health, Ambetter 

Revised

1/1/2026

X

WA.CP.MP.54

Hospice Services

Apple Health

Revised

1/1/2026

 

CP.MP.107 

DME 

Apple Health, Ambetter 

Revised

2/1/2026

 

CP.MP.202 

Orthognathic Surgery 

Apple Health, Ambetter 

Revised

2/1/2026

X

CP.MP.185

Skin Substitutes for Chronic Wounds

Ambetter 

Revised

4/1/2026

X

CP.MP.188

Pediatric Oral Function Therapy

Apple Health, Ambetter 

Revised

4/1/2026

X

CP.MP.247

Transplant Service Documentation Requirements

Apple Health, Ambetter 

Revised

4/1/2026

X

CP.MP.248

Facility Based Sleep Studies for Obstructive Sleep Apnea

Ambetter 

Revised

4/1/2026

 

ECG_7252 

Evolent - Ambulatory Rhythm Monitoring 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7254 

Evolent - Coronary Artery Bypass Graft 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7255 

Evolent - Aortic Valve Replacement 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7258 

Evolent - Device Interrogation and Programming 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7261 

Evolent - Device (AICD, CRT and/or Pacemaker) Battery Replacement 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7262 

Evolent - Diagnostic Electrophysiologic Testing 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7263 

Evolent - Cardiac Resynchronization Therapy 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7264 

Evolent - Renal Angiography and Intervention 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7266 

Evolent - Carotid Artery Stenting 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7268 

Evolent - Carotid Endarterectomy 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7269 

Evolent - Catheter Based Carotid, Brachiocephalic Arteriography, Venography, Intervention 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7282 

Evolent - Atrial Fibrillation Ablation 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7283 

Evolent - Abdominal Aortography w Bilateral Iliofemoral Lower Extremity Runoff 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7284 

Evolent - Catheter Ablation of Reentrant or Focal Tachydysrhythmias 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7286 

Evolent - Endomyocardial Biopsy 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7287 

Evolent - Endovascular Femoropopliteal Interventions 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7288 

Evolent - Endovascular Aortoiliac Interventions 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7289 

Evolent - Endovascular Infrapopliteal (Tibioperoneal) Interventions 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7290 

Evolent - Treatment of Varicose Veins 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7292 

Evolent - Infra-inguinal Open Arterial Vascular Surgery 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7295 

Evolent - Hearth Catheterization 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7299 

Evolent - Hemodialysis Access Creation 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7301 

Evolent - Implantable Cardioverter Defibrillator 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7302 

Evolent - Percutaneous Coronary Interventions 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7303 

Evolent - Interventions for Adults with Congenital Heart Defects 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7305 

Evolent - Introduction of Inferior Vena Cava Filter Device 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7310 

Evolent - Mitral Valve Surgery 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7315 

Evolent - Pacemaker Insertion 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7319 

Evolent - Percutaneous Iliocaval Interventions 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7320 

Evolent - Percutaneous Left Atrial Appendage Closure 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7327 

Evolent - Standalone Right Heart Catheterization 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7334 

Evolent - Transcatheter Aortic Valve Replacement (TAVR) 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7335 

Evolent - Transcatheter Edge to Edge Repair (TEER) of Mitral Valve 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7338 

Evolent - Tricuspid Valve Surgery 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7339 

Evolent - Ultrasound-Guided Vascular Access 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7341 

Evolent - Venogram Invasive Vein Mapping 

Apple Health, Ambetter 

New

1/1/2026

 

ECG_7345 

Evolent - Wireless Pulmonary Artery Pressure Device Placement and Monitoring 

Apple Health, Ambetter 

New

1/1/2026

X

WA.CP.MP.536

HCA HTCC Clinical Policy Alignment

Apple Health

New

1/1/2026

 

CC.PP.018 

Inpatient Only Procedures 

Apple Health

Archived

12/31/2025 

 

MP.PP.018 

Inpatient Only Procedures 

Ambetter 

Archived

12/31/2025 

 

WA.CP.MP.516 

Carotid Artery Stenting 

Apple Health, Ambetter 

Archived

12/31/2025 

 

WA.CP.MP.522 

Varicose Vein Treatment 

Apple Health, Ambetter 

Archived

12/31/2025 

 

WA.CP.MP.525 

Catheter Ablation for SVTA 

Apple Health, Ambetter 

Archived

12/31/2025 

 

WA.HIM.CP.MP.92 

Acupuncture 

Ambetter 

Archived

12/31/2025 

 

WA.CP.MP.513 

Cardiac Stents 

Apple Health, Ambetter 

Archived

12/31/25 

The following codes will require Pre-Authorization as of the listed Effective Date

Future changes to Pre-Authorization requirements are noted below. Utilize our Pre-Auth Check tool for real time response to pre authorization requirements.  

Code

Description

Line of Business

Effective Date

69714

Implantation, osseo-integrated implant, skull; with percutaneous attachment to external speech processor 

Apple Health

1/1/2026

69729

Implantation, osseo-integrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex 

Apple Health

1/1/2026

15734

MUSCLE-SKIN GRAFT TRUNK

Apple Health

2/1/2026

19301

PARTIAL MASTECTOMY

Apple Health

2/1/2026

19357

TISSUE EXPANDER PLACEMENT BREAST RECONSTRUCTION

Apple Health

2/1/2026

37243

VASC EMBOLIZE/OCCLUDE ORGAN

Apple Health

2/1/2026

43281

LAP PARAESOPHAG HERN REPAIR

Ambetter

2/1/2026

43282

LAP PARAESOPH HER RPR W/MESH

Ambetter

2/1/2026

49505

PRP I/HERN INIT REDUC >5 YR

Apple Health

2/1/2026

49591

RPR AA HERNIA 1ST < 3 CM REDUCIBLE

Apple Health

2/1/2026

49593

RPR AA HERNIA 1ST 3-10 CM REDUCIBLE

Apple Health

2/1/2026

49595

RPR AA HERNIA 1ST > 10 CM REDUCIBLE

Apple Health

2/1/2026

49650

LAP ING HERNIA REPAIR INIT

Apple Health

2/1/2026

54360

PENIS PLASTIC SURGERY

Apple Health

2/1/2026

55866

LAPARO RADICAL PROSTATECTOMY

Ambetter

2/1/2026

58541

LSH UTERUS 250 G OR LESS

Apple Health

2/1/2026

58573

TLH W/T/O UTERUS OVER 250 G

Apple Health

2/1/2026

58661

LAPAROSCOPY REMOVE ADNEXA

Apple Health

2/1/2026

58662

LAPAROSCOPY EXCISE LESIONS

Apple Health

2/1/2026

64999

NERVOUS SYSTEM SURGERY

Apple Health

2/1/2026

97155

ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN

Apple Health

2/1/2026

0340U

ONC PAN CANCER ANALYSIS MRD FROM PLASMA

Apple Health

2/1/2026

C1767

GENERATOR NEUROSTIM NONRECHARGEABLE

Apple Health

2/1/2026

H2022

CMTY-BASED WRAP-AROUND SRVC DIEM

Apple Health

2/1/2026

J2426

INJECTION PP LAI EXT RLS INVEGA SUSTENNA 1 MG

Apple Health

2/1/2026

L1833

KNEE ORTHOSIS ADJUST JNT RIGD SUPP

Apple Health

2/1/2026

Q4101

APLIGRAF PER SQ CM

Apple Health

2/1/2026

Q4121

THERASKIN PER SQ CM

Apple Health

2/1/2026

Q4160

NUSHIELD 1 SQUARE CM

Apple Health

2/1/2026

Q4195

PURAPLY PER SQ CM

Apple Health

2/1/2026

Q4196

PURAPLY AM PER SQ CM

Apple Health

2/1/2026

Q5001

HOSPICE/HOME HLTH CARE PT HOME/RES

Apple Health

2/1/2026

Q5002

HOSPICE/HHC PROV ASSTD LIVING FACL

Apple Health

2/1/2026

Q5003

HOSPICE CARE PRVO LTC/NON-SKILL NF

Apple Health

2/1/2026

With the implementation of the Evolent Interventional Cardiology program for both Ambetter and Apple Health on January 1, 2026, the following services will require prior authorization from Evolent as of January 1:

Code

Description

Line of Business

Effective Date

33202

Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach)

Apple Health,
Ambetter

1/1/2026

33203

Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy)

Apple Health,
Ambetter

1/1/2026

33206

Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial

Apple Health,
Ambetter

1/1/2026

33207

Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular

Apple Health,
Ambetter

1/1/2026

33208

Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular

Apple Health,
Ambetter

1/1/2026

33210

Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure)

Apple Health,
Ambetter

1/1/2026

33211

Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)

Apple Health,
Ambetter

1/1/2026

33212

Insertion of Pacemaker Pulse Generator Only; with Existing single Lead

Apple Health,
Ambetter

1/1/2026

33213

Insertion of Pacemaker Pulse Generator Only; with Existing Dual Leads

Apple Health,
Ambetter

1/1/2026

33214

Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator)

Apple Health,
Ambetter

1/1/2026

33215

Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode

Apple Health,
Ambetter

1/1/2026

33216

Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator

Apple Health,
Ambetter

1/1/2026

33217

Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator

Apple Health,
Ambetter

1/1/2026

33218

Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator

Apple Health,
Ambetter

1/1/2026

33220

Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator

Apple Health,
Ambetter

1/1/2026

33221

Insertion of Pacemaker Pulse Generator Only; with Existing Multiple Leads

Apple Health,
Ambetter

1/1/2026

33222

Relocation of Skin Pocket for Pacemaker

Apple Health,
Ambetter

1/1/2026

33223

Relocation of skin pocket for implantable defibrillator

Apple Health,
Ambetter

1/1/2026

33224

Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of pocket, removal, insertion, and/or replacement of existing generator)

Apple Health,
Ambetter

1/1/2026

33225

Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33226

Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator)

Apple Health,
Ambetter

1/1/2026

33227

Removal of Permanent Pacemaker Pulse Generator with Replacement of Pacemaker Pulse Generator; single Lead System

Apple Health,
Ambetter

1/1/2026

33228

Removal of Permanent Pacemaker Pulse Generator with Replacement of Pacemaker Pulse Generator; Dual Lead System

Apple Health,
Ambetter

1/1/2026

33229

Removal of Permanent Pacemaker Pulse Generator with Replacement of Pacemaker Pulse Generator; Multiple Lead System

Apple Health,
Ambetter

1/1/2026

33230

Insertion of implantable defibrillator pulse generator only; with existing dual leads

Apple Health,
Ambetter

1/1/2026

33231

Insertion of implantable defibrillator pulse generator only; with existing multiple leads

Apple Health,
Ambetter

1/1/2026

33233

Removal of permanent pacemaker pulse generator only

Apple Health,
Ambetter

1/1/2026

33234

Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular

Apple Health,
Ambetter

1/1/2026

33235

Removal of transvenous pacemaker electrode(s); dual lead system

Apple Health,
Ambetter

1/1/2026

33236

Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular

Apple Health,
Ambetter

1/1/2026

33237

Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system

Apple Health,
Ambetter

1/1/2026

33240

Insertion of implantable defibrillator pulse generator only; with existing single lead

Apple Health,
Ambetter

1/1/2026

33241

Removal of implantable defibrillator pulse generator only

Apple Health,
Ambetter

1/1/2026

33243

Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy

Apple Health,
Ambetter

1/1/2026

33244

Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction

Apple Health,
Ambetter

1/1/2026

33249

Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber

Apple Health,
Ambetter

1/1/2026

33262

Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system

Apple Health,
Ambetter

1/1/2026

33263

Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system

Apple Health,
Ambetter

1/1/2026

33264

Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system

Apple Health,
Ambetter

1/1/2026

33270

Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters, when performed

Apple Health,
Ambetter

1/1/2026

33271

Insertion of subcutaneous implantable defibrillator electrode

Apple Health,
Ambetter

1/1/2026

33272

Removal of subcutaneous implantable defibrillator electrode

Apple Health,
Ambetter

1/1/2026

33273

Repositioning of previously implanted subcutaneous implantable defibrillator electrode

Apple Health,
Ambetter

1/1/2026

33274

Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed

Apple Health,
Ambetter

1/1/2026

33275

Transcatheter removal of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography), when performed

Apple Health,
Ambetter

1/1/2026

33285

Insertion, subcutaneous cardiac rhythm monitor, including programming

Apple Health,
Ambetter

1/1/2026

33286

Removal, subcutaneous cardiac rhythm monitor

Apple Health,
Ambetter

1/1/2026

33361

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach

Apple Health,
Ambetter

1/1/2026

33362

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach

Apple Health,
Ambetter

1/1/2026

33363

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open axillary artery approach

Apple Health,
Ambetter

1/1/2026

33364

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac artery approach

Apple Health,
Ambetter

1/1/2026

33365

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy)

Apple Health,
Ambetter

1/1/2026

33366

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transapical exposure (eg, left thoracotomy)

Apple Health,
Ambetter

1/1/2026

33367

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33368

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33369

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33405

Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve

Apple Health,
Ambetter

1/1/2026

33406

Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand)

Apple Health,
Ambetter

1/1/2026

33410

Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve

Apple Health,
Ambetter

1/1/2026

33411

Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus

Apple Health,
Ambetter

1/1/2026

33412

Replacement, aortic valve; with transventricular aortic annulus enlargement (Konno procedure)

Apple Health,
Ambetter

1/1/2026

33413

Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (Ross procedure)

Apple Health,
Ambetter

1/1/2026

33418

Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis

Apple Health,
Ambetter

1/1/2026

33419

Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33425

Valvuloplasty, mitral valve, with cardiopulmonary bypass;

Apple Health,
Ambetter

1/1/2026

33426

Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring

Apple Health,
Ambetter

1/1/2026

33427

Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring

Apple Health,
Ambetter

1/1/2026

33430

Replacement, Mitral Valve, with Cardiopulmonary Bypass

Apple Health,
Ambetter

1/1/2026

33440

Replacement, aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve (Ross-Konno procedure)

Apple Health,
Ambetter

1/1/2026

33465

Replacement, Tricuspid Valve, with Cardiopulmonary Bypass

Apple Health,
Ambetter

1/1/2026

33475

Replacement, Pulmonary Valve

Apple Health,
Ambetter

1/1/2026

33477

Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed

Apple Health,
Ambetter

1/1/2026

33510

Coronary artery bypass, vein only; single coronary venous graft

Apple Health,
Ambetter

1/1/2026

33511

Coronary artery bypass, vein only; 2 coronary venous grafts

Apple Health,
Ambetter

1/1/2026

33512

Coronary artery bypass, vein only; 3 coronary venous grafts

Apple Health,
Ambetter

1/1/2026

33513

Coronary artery bypass, vein only; 4 coronary venous grafts

Apple Health,
Ambetter

1/1/2026

33514

Coronary artery bypass, vein only; 5 coronary venous grafts

Apple Health,
Ambetter

1/1/2026

33516

Coronary artery bypass, vein only; 6 or more coronary venous grafts

Apple Health,
Ambetter

1/1/2026

33517

Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33518

Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33519

Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33521

Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33522

Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33523

Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33530

Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33533

Coronary Artery Bypass, Using Arterial Graft(S); single Arterial Graft

Apple Health,
Ambetter

1/1/2026

33534

Coronary Artery Bypass, Using Arterial Graft(S); 2 Coronary Arterial Grafts

Apple Health,
Ambetter

1/1/2026

33535

Coronary Artery Bypass, Using Arterial Graft(S); 3 Coronary Arterial Grafts

Apple Health,
Ambetter

1/1/2026

33536

Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts

Apple Health,
Ambetter

1/1/2026

33572

Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (List separately in addition to primary procedure)

Apple Health,
Ambetter

1/1/2026

33641

Repair atrial Septal Defect, Secundum, with Cardiopulmonary Bypass, with or without Patch

Apple Health,
Ambetter

1/1/2026

33768

Anastomosis, cavopulmonary, second superior vena cava (List separately in addition to primary procedure)

Apple Health,
Ambetter

1/1/2026

33820

Repair of patent ductus arteriosus; by ligation

Apple Health,
Ambetter

1/1/2026

33840

Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis

Apple Health,
Ambetter

1/1/2026

33900

Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral

Apple Health,
Ambetter

1/1/2026

33901

Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral

Apple Health,
Ambetter

1/1/2026

33902

Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral

Apple Health,
Ambetter

1/1/2026

33903

Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral

Apple Health,
Ambetter

1/1/2026

33904

Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

33917

Repair of pulmonary artery stenosis by reconstruction with patch or graft

Apple Health,
Ambetter

1/1/2026

33924

Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

35001

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision

Apple Health,
Ambetter

1/1/2026

35011

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision

Apple Health,
Ambetter

1/1/2026

35141

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral artery (profunda femoris, superficial femoral)

Apple Health,
Ambetter

1/1/2026

35151

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal artery

Apple Health,
Ambetter

1/1/2026

35301

Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision

Apple Health,
Ambetter

1/1/2026

35302

Thromboendarterectomy, including patch graft, if performed; superficial femoral artery

Apple Health,
Ambetter

1/1/2026

35303

Thromboendarterectomy, including patch graft, if performed; popliteal artery

Apple Health,
Ambetter

1/1/2026

35304

Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery

Apple Health,
Ambetter

1/1/2026

35305

Thromboendarterectomy, including patch graft, if performed; tibial or peroneal artery, initial vessel

Apple Health,
Ambetter

1/1/2026

35306

Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

35351

Thromboendarterectomy, including Patch Graft, If Performed; Iliac

Apple Health,
Ambetter

1/1/2026

35355

Thromboendarterectomy, including Patch Graft, If Performed; Iliofemoral

Apple Health,
Ambetter

1/1/2026

35371

Thromboendarterectomy, including Patch Graft, If Performed; Common Femoral

Apple Health,
Ambetter

1/1/2026

35372

Thromboendarterectomy, including Patch Graft, If Performed; Deep (Profunda) Femoral

Apple Health,
Ambetter

1/1/2026

35390

Reoperation, carotid, thromboendarterectomy, more than 1 month after original operation (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

35400

Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

35500

Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

35556

Bypass Graft, with Vein; Femoral-Popliteal

Apple Health,
Ambetter

1/1/2026

35558

Bypass Graft, with Vein; Femoral-Femoral

Apple Health,
Ambetter

1/1/2026

35566

Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels

Apple Health,
Ambetter

1/1/2026

35571

Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels

Apple Health,
Ambetter

1/1/2026

35572

Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

35583

In-situ vein bypass; femoral-popliteal

Apple Health,
Ambetter

1/1/2026

35585

In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery

Apple Health,
Ambetter

1/1/2026

35587

In-situ vein bypass; popliteal-tibial, peroneal

Apple Health,
Ambetter

1/1/2026

35600

Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, open

Apple Health,
Ambetter

1/1/2026

35621

Bypass Graft, with Other than Vein; Axillary-Femoral

Apple Health,
Ambetter

1/1/2026

35646

Bypass Graft, with Other than Vein; Aortobifemoral

Apple Health,
Ambetter

1/1/2026

35654

Bypass Graft, with Other than Vein; Axillary-Femoral-Femoral

Apple Health,
Ambetter

1/1/2026

35656

Bypass Graft, with Other than Vein; Femoral-Popliteal

Apple Health,
Ambetter

1/1/2026

35661

Bypass graft, with other than vein; femoral-femoral

Apple Health,
Ambetter

1/1/2026

35665

Bypass Graft, with Other than Vein; Iliofemoral

Apple Health,
Ambetter

1/1/2026

35666

Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery

Apple Health,
Ambetter

1/1/2026

35671

Bypass graft, with other than vein; popliteal-tibial or -peroneal artery

Apple Health,
Ambetter

1/1/2026

35700

Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

35881

Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition

Apple Health,
Ambetter

1/1/2026

35883

Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with nonautogenous patch graft (eg, Dacron, ePTFE, bovine pericardium)

Apple Health,
Ambetter

1/1/2026

35884

Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft

Apple Health,
Ambetter

1/1/2026

36005

Injection procedure for extremity venography (including introduction of needle or intracatheter)

Apple Health,
Ambetter

1/1/2026

36140

Introduction of needle or intracatheter, upper or lower extremity artery

Apple Health,
Ambetter

1/1/2026

36200

Introduction of Catheter, Aorta

Apple Health,
Ambetter

1/1/2026

36215

Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family

Apple Health,
Ambetter

1/1/2026

36216

Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family

Apple Health,
Ambetter

1/1/2026

36217

Selective Catheter Placement, Arterial System; initial Third order or More Selective Thoracic or Brachiocephalic Branch, within A Vascular Family

Apple Health,
Ambetter

1/1/2026

36218

Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (List in addition to code for initial second or third order vessel as appropriate)

Apple Health,
Ambetter

1/1/2026

36221

Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed

Apple Health,
Ambetter

1/1/2026

36245

Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family

Apple Health,
Ambetter

1/1/2026

36246

Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family

Apple Health,
Ambetter

1/1/2026

36247

Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family

Apple Health,
Ambetter

1/1/2026

36251

Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; unilateral

Apple Health,
Ambetter

1/1/2026

36252

Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; bilateral

Apple Health,
Ambetter

1/1/2026

36253

Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; unilateral

Apple Health,
Ambetter

1/1/2026

36254

Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; bilateral

Apple Health,
Ambetter

1/1/2026

36465

Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)

Apple Health,
Ambetter

1/1/2026

36466

Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg

Apple Health,
Ambetter

1/1/2026

36473

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated

Apple Health,
Ambetter

1/1/2026

36474

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

36475

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated

Apple Health,
Ambetter

1/1/2026

36476

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

36478

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated

Apple Health,
Ambetter

1/1/2026

36479

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

36482

Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated

Apple Health,
Ambetter

1/1/2026

36483

Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

36836

Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiologic supervision and interpretation

Apple Health,
Ambetter

1/1/2026

36837

Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiologic supervision and interpretation

Apple Health,
Ambetter

1/1/2026

37215

Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection

Apple Health,
Ambetter

1/1/2026

37236

Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery

Apple Health,
Ambetter

1/1/2026

37237

Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s)  for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; each additional artery (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37238

Transcatheter Placement of An Intravascular Stent(S), Open or Percutaneous, including Radiological Supervision and Interpretation and including Angioplasty within the Same Vessel, when Performed; initial Vein

Apple Health,
Ambetter

1/1/2026

37239

Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37246

Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery

Apple Health,
Ambetter

1/1/2026

37247

Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; each additional artery (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37248

Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein

Apple Health,
Ambetter

1/1/2026

37249

Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37254

Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37255

Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37256

Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37257

Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37258

Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37259

Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37260

Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37261

Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37263

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37264

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37265

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37266

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37267

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37268

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37269

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37270

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37271

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the atherectomy and angioplasty when performed, within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37272

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the atherectomy and angioplasty when performed, within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37273

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the atherectomy and angioplasty when performed, within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37274

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the atherectomy and angioplasty when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37275

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement, atherectomy, and angioplasty when performed, within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37276

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement, atherectomy, and angioplasty when performed, within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37277

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement, atherectomy, and angioplasty when performed, within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37278

Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement, atherectomy, and angioplasty when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37280

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37281

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37282

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37283

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; complex lesion, complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37284

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37285

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37286

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37287

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement and angioplasty when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37288

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the atherectomy and angioplasty when performed, within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37289

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the atherectomy and angioplasty when performed, within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37290

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the atherectomy and angioplasty when performed, within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37291

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the atherectomy and angioplasty when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37292

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement, atherectomy, and angioplasty when performed, within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37293

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement, atherectomy, and angioplasty when performed, within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37294

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement, atherectomy, and angioplasty when performed, within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37295

Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the stent placement, atherectomy, and angioplasty when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37296

Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; straightforward lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37297

Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; straightforward lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37298

Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; complex lesion, initial vessel

Apple Health,
Ambetter

1/1/2026

37299

Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

37765

Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions

Apple Health,
Ambetter

1/1/2026

37766

Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions

Apple Health,
Ambetter

1/1/2026

75580

Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional

Apple Health,
Ambetter

1/1/2026

75625

Aortography, abdominal, by serialography, radiological supervision and interpretation

Apple Health,
Ambetter

1/1/2026

75630

Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation

Apple Health,
Ambetter

1/1/2026

75710

Angiography, extremity, unilateral, radiological supervision and interpretation

Apple Health,
Ambetter

1/1/2026

75716

Angiography, extremity, bilateral, radiological supervision and interpretation

Apple Health,
Ambetter

1/1/2026

75726

Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation

Apple Health,
Ambetter

1/1/2026

75736

Angiography, pelvic, selective or supraselective, radiological supervision and interpretation

Apple Health,
Ambetter

1/1/2026

76937

Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

76984

Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic

Apple Health,
Ambetter

1/1/2026

76987

Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report

Apple Health,
Ambetter

1/1/2026

76988

Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only

Apple Health,
Ambetter

1/1/2026

76989

Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only

Apple Health,
Ambetter

1/1/2026

92920

Percutaneous Transluminal Coronary Angioplasty; single Major Coronary Artery or Branch

Apple Health,
Ambetter

1/1/2026

92924

Percutaneous Transluminal Coronary atherectomy, with Coronary Angioplasty when Performed; single Major Coronary Artery or Branch

Apple Health,
Ambetter

1/1/2026

92928

Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch

Apple Health,
Ambetter

1/1/2026

92930

Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring angioplasty and/or stenting in both the main artery and the side branch

Apple Health,
Ambetter

1/1/2026

92933

Percutaneous Transluminal Coronary atherectomy, with Intracoronary Stent, with Coronary Angioplasty when Performed; single Major Coronary Artery or Branch

Apple Health,
Ambetter

1/1/2026

92937

Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel

Apple Health,
Ambetter

1/1/2026

92943

Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel

Apple Health,
Ambetter

1/1/2026

92960

Cardioversion, elective, electrical conversion of arrhythmia; external

Apple Health,
Ambetter

1/1/2026

92961

Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure)

Apple Health,
Ambetter

1/1/2026

92972

Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

92973

Percutaneous transluminal coronary thrombectomy mechanical (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

92974

Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

92978

Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

92979

Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

92986

Percutaneous balloon valvuloplasty; aortic valve

Apple Health,
Ambetter

1/1/2026

92987

Percutaneous balloon valvuloplasty; mitral valve

Apple Health,
Ambetter

1/1/2026

92997

Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel

Apple Health,
Ambetter

1/1/2026

92998

Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93292

Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system

Apple Health,
Ambetter

1/1/2026

93451

Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed

Apple Health,
Ambetter

1/1/2026

93452

Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed

Apple Health,
Ambetter

1/1/2026

93453

Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed

Apple Health,
Ambetter

1/1/2026

93454

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;

Apple Health,
Ambetter

1/1/2026

93455

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography

Apple Health,
Ambetter

1/1/2026

93456

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization

Apple Health,
Ambetter

1/1/2026

93457

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization

Apple Health,
Ambetter

1/1/2026

93458

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed

Apple Health,
Ambetter

1/1/2026

93459

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography

Apple Health,
Ambetter

1/1/2026

93460

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed

Apple Health,
Ambetter

1/1/2026

93461

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography

Apple Health,
Ambetter

1/1/2026

93462

Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93463

Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93464

Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93505

Endomyocardial Biopsy

Apple Health,
Ambetter

1/1/2026

93563

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93564

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aortocoronary saphenous vein, free radial artery, or free mammary artery graft) to one or more coronary arteries and in situ arterial conduits (eg, internal mammary), whether native or used for bypass to one or more coronary arteries during congenital heart catheterization, when performed (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93565

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93566

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93567

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93568

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for pulmonary angiography (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93569

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93571

Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; initial vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93572

Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; each additional vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93573

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93574

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93575

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart defects, each distinct vessel (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93580

Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant

Apple Health,
Ambetter

1/1/2026

93581

Percutaneous transcatheter closure of a congenital ventricular septal defect with implant

Apple Health,
Ambetter

1/1/2026

93582

Percutaneous transcatheter closure of patent ductus arteriosus

Apple Health,
Ambetter

1/1/2026

93583

Percutaneous Transcatheter Septal Reduction therapy (Eg, Alcohol Septal Ablation) including Temporary Pacemaker Insertion when Performed

Apple Health,
Ambetter

1/1/2026

93584

Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93585

Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93586

Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93587

Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93588

Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93590

Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve

Apple Health,
Ambetter

1/1/2026

93591

Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve

Apple Health,
Ambetter

1/1/2026

93592

Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93609

Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93613

Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93619

Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia

Apple Health,
Ambetter

1/1/2026

93620

Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording

Apple Health,
Ambetter

1/1/2026

93621

Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93622

Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93623

Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93650

Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement

Apple Health,
Ambetter

1/1/2026

93653

Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensional mapping, right ventricular pacing and recording, left atrial pacing and recording from coronary sinus or left atrium, and His bundle recording, when performed; with treatment of supraventricular tachycardia by ablation of fast or slow atrioventricular pathway, accessory atrioventricular connection, cavo-tricuspid isthmus or other single atrial focus or source of atrial re-entry

Apple Health,
Ambetter

1/1/2026

93654

Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensional mapping, right ventricular pacing and recording, left atrial pacing and recording from coronary sinus or left atrium, and His bundle recording, when performed; with treatment of ventricular tachycardia or focus of ventricular ectopy including left ventricular pacing and recording, when performed

Apple Health,
Ambetter

1/1/2026

93655

Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrhythmia (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93656

Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, and intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation, including intracardiac electrophysiologic 3-dimensional mapping, intracardiac echocardiography with imaging supervision and interpretation, right ventricular pacing/recording, and His bundle recording, when performed

Apple Health,
Ambetter

1/1/2026

93657

Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93662

Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure)

Apple Health,
Ambetter

1/1/2026

93745

Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ECG, transmission of data to data repository, patient instruction in wearing system and patient reporting of problems or events

Apple Health,
Ambetter

1/1/2026

C1721

CARDIOVERT-DEFIBRILLATOR DUAL CHAMB

Apple Health,
Ambetter

1/1/2026

C1722

CARDIOVERT-DEFIB SINGLE CHAMB

Apple Health,
Ambetter

1/1/2026

C1730

CATH EP DX OTH THAN 3D MAP 19/<

Apple Health,
Ambetter

1/1/2026

C1731

CATH EP DX OTH THAN 3D MAP 20/>

Apple Health,
Ambetter

1/1/2026

C1732

CATH EP DX/ABLAT 3D/VECTOR MAP

Apple Health,
Ambetter

1/1/2026

C1733

CATH EP DX/ABLAT NOT MAP/COOL-TIP

Apple Health,
Ambetter

1/1/2026

C1753

CATHETER INTRAVASCULAR ULTRASOUND

Apple Health,
Ambetter

1/1/2026

C1759

CATHETER INTRACARD ECHOCARDIOGRAPHY

Apple Health,
Ambetter

1/1/2026

C1760

CLOSURE DEVICE VASCULAR

Apple Health,
Ambetter

1/1/2026

C1764

EVENT RECORDER CARDIAC

Apple Health,
Ambetter

1/1/2026

C1768

GRAFT VASCULAR

Apple Health,
Ambetter

1/1/2026

C1777

LEAD CARDIOVRT-DFIB ENDOCARD 1 COIL

Apple Health,
Ambetter

1/1/2026

C1779

LEAD PACEMKR TRNS VDD SINGLE PASS

Apple Health,
Ambetter

1/1/2026

C1785

PACEMKR DUAL CHAMB RATE-RESPONSIVE

Apple Health,
Ambetter

1/1/2026

C1786

PACEMKR 1 CHAMB RATE-RESPONSIVE

Apple Health,
Ambetter

1/1/2026

C1876

STNT NON-COATED/NON-COVR DELIV SYS

Apple Health,
Ambetter

1/1/2026

C1877

STNT NON-COAT/NON-COVR W/O DEL SYS

Apple Health,
Ambetter

1/1/2026

C1882

CARDIOVRT-DFIB OTH THAN 1/DUL CHAMB

Apple Health,
Ambetter

1/1/2026

C1895

LEAD CARDIOVRT-DFIB ENDOCARD DUL

Apple Health,
Ambetter

1/1/2026

C1896

LEAD CARDIOVRT-DFIB NOT ENDOCARD

Apple Health,
Ambetter

1/1/2026

C1898

LEAD PACEMKR NOT TRNS VDD 1 PASS

Apple Health,
Ambetter

1/1/2026

C1899

LEAD PACEMKR/CARDIOVERT-DEFIB COMB

Apple Health,
Ambetter

1/1/2026

C1900

LEAD LT VENTRICULAR CORON VENUS SYS

Apple Health,
Ambetter

1/1/2026

C2617

STENT NON-COR TEMP W/O DELIV SYSTEM

Apple Health,
Ambetter

1/1/2026

C2619

PACEMKR DUL CHAMB NON RATE-RESPONS

Apple Health,
Ambetter

1/1/2026

C2620

PACEMKR 1 CHAMB NON RATE-RESPONSIVE

Apple Health,
Ambetter

1/1/2026

C2621

PACEMKR OTH THAN SINGLE/DUAL CHAMB

Apple Health,
Ambetter

1/1/2026

C2623

CATHETER TA DRUG-COATED NON-LASER

Apple Health,
Ambetter

1/1/2026

C2630

CATH EP DX/ABLAT NOT MAP COOL-TIP

Apple Health,
Ambetter

1/1/2026

C9600

PERQ TRANSCATH PLCMT; 1 MAJ CA/BR

Apple Health,
Ambetter

1/1/2026

C9601

PC TRNSCATH PLCMT; EA ADD BR MAJ CA

Apple Health,
Ambetter

1/1/2026

C9602

PERQ TL CORONARY ATHERECT; 1 MCA/BR

Apple Health,
Ambetter

1/1/2026

C9603

PERQ TL COR ATHERECT;EA ADD BR MCA

Apple Health,
Ambetter

1/1/2026

C9604

PERQ TL REVISION OF/THRU CABG;1 VES

Apple Health,
Ambetter

1/1/2026

C9605

PERQ TL REV OF/THRU CABG;EA ADD BR

Apple Health,
Ambetter

1/1/2026

C9606

PC TL REV AC TOT/SUBTOT OCCL 1 VES

Apple Health,
Ambetter

1/1/2026

C9607

PERQ TL REV CHRN TOT OCCL; 1 VESSEL

Apple Health,
Ambetter

1/1/2026

C9608

PC TL REV CHRN TOT OCCL; EA ADD BR

Apple Health,
Ambetter

1/1/2026

E0616

Implantable cardiac event recorder with memory, activator, and programmer

Apple Health,
Ambetter

1/1/2026

G0278

Iliac and/or Femoral Angiography at Time of Cath

Apple Health,
Ambetter

1/1/2026

K0606

Automatic external defibrillator, with integrated electrocardiogram analysis, garment type

Apple Health,
Ambetter

1/1/2026

K0607

Replacement battery for automated external defibrillator, garment type only, each

Apple Health,
Ambetter

1/1/2026

K0608

Replacement garment for use with automated external defibrillator, each

Apple Health,
Ambetter

1/1/2026

K0609

Replacement electrodes for use with automated external defibrillator, garment type only, each

Apple Health,
Ambetter

1/1/2026

Back to Top

______________________________________________________________________________________

Wellcare

Please see the Wellcare Website for the latest upcoming policy changes going into effect February 9th. https://www.wellcare.com/providers/medicare-bulletins/medical-clinical-policy-updates

Back to Top

______________________________________________________________________________________

Apple Health Core Connections

FREE Adoption Competency Training! The Center for Adoption Support and Education has updated its National Adoption Competency Mental Health Training Initiative. NTI is state-of-the-art, web-based training to enhance the capacity of child welfare and mental health professionals to effectively address the complex mental health needs of children in foster care, moving to permanency through adoption or guardianship or living with their adoptive or guardianship families.

NTI Training for Mental Health Professionals (26.5 hours) was designed for behavioral/mental health professionals in public and private agency, community-based, or residential settings, as well as private practitioners. NTI provides foundational knowledge to more effectively address the unique adoption-related issues that arise throughout the lifespan of the adoptive or guardianship/ kinship family. This includes work with children and youth in foster care, adoptees, birth families, adoptive/kinship families. 

This training is approved by the National Association of Social Workers (NASW) and National Board of Certified Counselors (NBCC) for 26.5 continuing education credits for individuals who enroll through C.A.S.E. on the C.A.S.E. LMS (Use Enrollment Key: NTIMHP2021) and pass the module post-tests at 80%. 

https://adoptionsupport.org/

https://case.myabsorb.com/#/

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Training/Education 

Evolent training sessions

Evolent training sessions will be scheduled for several dates beginning in December. For additional program details and to register for training, please visit the Evolent resource page. For program changes effective January 1. https://go.evolent.com/coordinated-care-program-changes-january-1-2026

Full link: https://go.evolent.com/coordinated-care-program-changes-january-1-2026

Cultural Care & Connections: Supporting Native American Tribal Families and Youth This training explores the importance of honoring cultural differences when caring for Native American children and youth, particularly those placed outside of their tribal communities. Participants will gain insight of tribal communities, as well as the impact of historical and intergenerational trauma. The training also helps caregivers identify potential cultural barriers— including in areas of personal care—and provides strategies for offering respectful, inclusive support. Emphasis is placed on the vital need to keep Native children connected to their tribal heritage, extended family, and community in alignment with the Indian Child Welfare Act (ICWA) and tribal sovereignty. Jan 6, 2026, 11:00 AM https://centene.zoom.us/meeting/register/cgvsP2DZTSuVmwULd07QdA

Trauma 101 What is Trauma? This training answers this question by defining trauma, how trauma affects children, and what caregivers can do to assist children. The presentation will heighten the caregiver’s awareness of children’s cues so they will know what to expect and how to respond when a child experiences trauma triggers. Jan 7, 2026, 01:00 PM https://centene.zoom.us/meeting/register/z3vems5pSkaevRMEoRoS1A

Childhood Development & The Impact of Trauma This training provides information on key areas of childhood development; social, cognitive, and physical development are all explored. The training focuses on how complex trauma effects development in infants and toddlers, school aged children, and adolescents. Jan 14, 2026 12:00 PM Pacific https://centene.zoom.us/j/96686731324?pwd=lb3N9rmBoyxDy0dCbGAR9t06ByjEFg.1

Suicide Prevention in Youth:  Provides an overview of the topic of suicide, signs and symptoms in youth, and how professionals and caregivers should respond in times of crisis. The training will dive into the rates of youth suicide, risk factors, and proactive steps to take for prevention. Will include a discussion on self-harm and social media. This training has many resources to utilize, as well as being useful for concerns of suicidal ideation in adults as well.  Jan 7, 2026 06:00 - 08:00pm  https://centene.zoom.us/meeting/register/3hcXpz-lRMO6sg6MMEuuuw

Attachment: Beyond Infancy:  Attachment is the foundation of all relationships, and when caring for children with a history of trauma and trust issues, it does not always occur easily. Lack of bonding is often a core reason why caretakers and children have challenges in placement and/or disrupt from the home. This training addresses the need for Attachment-Focused care, including some practical tips on how to strengthen connections to children. This training can help caregivers and professionals understand the basics of how attachment issues are extremely common in children who have experienced complex trauma, and what behaviors may come from that history.  Jan 15, 2026 06:00 -08:00pm

https://centene.zoom.us/meeting/register/mQMh1YGVS2aCbD0_QcpObg

ACE's (Adverse Childhood Experiences): This training explains the Adverse Childhood Experiences (ACEs) study and identifies all 10 ACEs. All childhood experiences, especially traumatic events, have an impact on people as they mature. This training explores the long term effects that adverse childhood experiences have on physical and mental health. Preventative measures, resiliency, and how to address the needs of children with a high ACEs score are all discussed. Personal ACE's test provided. Jan 28,2026 06:00 - 08:00pm   https://centene.zoom.us/meeting/register/65nzbI9bRpa0ssqoJU1jnw

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Pharmacy Updates 

NPI Prescriber Enforcement for Pharmacy Claims- Medicaid

Action Required: In accordance with 42 CFR 438.602(b), all prescribers must be registered with the Health Care Authority (HCA). Effective April 1, 2026, any prescription submitted by a prescriber not recognized by the HCA will be rejected at pharmacy point of sale, some exceptions may apply. Please visit Enroll as a provider | Washington State Health Care Authority for more information on how to enroll as a provider with the HCA.

https://www.hca.wa.gov/billers-providers-partners/become-apple-health-provider/enroll-provider

Pharmacy Clinical Policy Updates- Medicaid & Ambetter

The following pharmacy policies have been updated and will be posted on the policy site, including a description of revisions at https://www.coordinatedcarehealth.com/providers/resources/clinical-payment-policies.html.

Policy Number

Policy Title

Effective Date

Line of Business

WA.PHAR.49.AB

IL4 IL 13 Inhibitors

01/01/2026

Medicaid

WA.PHAR.49.AH

CAM-JAK Inhibitors

01/01/2026

Medicaid

WA.PHAR.81

Proton Pump Inhibitors (PPI)

01/01/2026

Medicaid

WA.PHAR.28

Androgenic Agents- Testosterone Replacement Therapy (TRT)

01/01/2026

Medicaid

CP.PHAR.103

Immune Globulins

01/01/2026

Medicaid

CP.PMN.154

Isavuconazonium (Cresemba)

01/01/2026

Medicaid & Ambetter

CP.PHAR.759

Nerandomilast (Jascayd)

01/01/2026

Medicaid & Ambetter

CP.PMN.156

Perampanel (Fycompa)

01/01/2026

Medicaid & Ambetter

CP.PMN.33

Pregabalin (Lyrica, Lyrica CR)

01/01/2026

Medicaid & Ambetter

CP.PHAR.725

Tiopronin Delayed-Release (Thiola EC)

01/01/2026

Medicaid & Ambetter

Evolent Medical Oncology Update- Ambetter

Prior Authorization requests for the following HCPCS codes need to be verified by Evolent.

HCPCS

Generic Name

Brand Name

Medical PA

Pharmacy PA

Impact Description

C9399​

CARBOPLATIN INJECTION ​

KYXATA​

Yes​

Yes​

·         FDA new release/approval 8/8/25 ​

·         Centene PA effective date 4/1/26​

J9999​

CARBOPLATIN INJECTION ​

KYXATA​

Yes​

Yes​

·         FDA new release/approval 8/8/25 ​

·         Centene PA effective date 4/1/26​

J9999​

PEMBROLIZUMAB AND​
BERAHYALURONIDASE ALFA-PMPH​
INJECTION​

KEYTRUDA QLEX​

Yes​

Yes​

·         FDA new release/approval 9/19/25 ​

·         Centene PA effective date 4/1/26​

J3590​

DENOSUMAB-QBDE ENOBY INJECTION ​

ENOBY​

Yes​

Yes​

·         FDA new release/ approval 9/26/25​

·         Centene PA effective date 4/1/26​

J3590​

DENOSUMAB-QBDE XTRENBO​
INJECTION​

XTRENBO​

Yes​

Yes​

·         FDA new release/approval 9/26/25​

·         Centene PA effective date 4/1/26​

J9999​

LEUPROLIDE INJECTION​

CAMCEVI ETM​

Yes​

Yes​

·         FDA new release/approval 8/28/25​

·         Centene PA effective date 4/1/26​

C9307​

LINVOSELTAMAB-GCPT INJECTION​

LYNOZYFIC​

Yes​

Yes​

·         New code, CMS effective date 1/1/26 ​

·         Centene PA effective 4/1/26​

C9308​

CARBOPLATIN (AVYXA) INJECTION​

KYXATA​

Yes​

Yes​

·         New code, CMS effective date 1/1/26​

·         Centene PA effective 4/1/26​

J0162​

EPINEPHRINE [FRESNIUS KABI)​
INJECTION​

EPINEPHRINE​

No​

No​

·         New code, CMS effective date 1/1/26​​

·         Centene PA effective 4/1/26​

J9184​

GEMCITABINE (AVGEMSI) ​
INJECTION​

AVGEMSI​

Yes​

Yes​

·         New code, CMS effective date 1/1/26 ​

·         Replace J9999

·         Centene PA effective 4/1/26​

J9282​

MITOMYCIN SOLUTION​

ZUSDURI​

Yes​

Yes​

·         New code, CMS effective date 1/1/26 ​

·         Replace J9999

·         Centene PA effective 4/1/26​

J9326​

TELISOTUZUMAB VEDOTIN-TLLV​
INJECTION​

EMRELIS​

Yes​

Yes​

·         New code, CMS effective date 1/1/26 ​

·         Replace J9999 & C9306

·         Centene PA effective 4/1/26​

Q5160​

BEVACIZUMAB-NWGD ​
INJECTION​

JOBEVNE​

Yes​

Yes​

·         New code, CMS effective date 1/1/26 ​

·         Replace J9999

·         Centene PA effective 4/1/26​

J3590​

DENOSUMAB-DESU JUBEREQ​
INJECTION​

JUBEREQ​

Yes​

Yes​

·         FDA new release approval 11/20/25​

·         Biosimilar to Xgeva-has PA​

·         Centene PA effective 4/1/26​

J3590​

DENOSUMAB-DESU OSVYRTI​
INJECTION​

OSVYRTI​

Yes​

Yes​

·         FDA new release approval 11/20/25​

·         Biosimilar to Prolia-has PA​

·         Centene PA effective 4/1/26​

J8999​

SEVABERTINIB ORAL​

HYRNUO​

Yes​

Yes​

·         FDA new release approval 11/19/25 ​

·         Centene PA effective 4/1/26​

J8999​

ZIFTOMENIB ORAL​

KOMZIFTI​

Yes​

Yes​

·         FDA new release approval 11/13/25 ​

·         Centene PA effective 4/1/26​

J9217​

LEUPROLIDE ACETATE SUSPENSION​
(VABRINTY)​

VABRINTY​

Yes​

Yes​

·         Added to Evolent review scope 12/15/25​

·         Centene PA effective 4/1/26​

J9999​

BELANTAMAB MAFODOTIN-BLMF​
INJECTION​

BLENREP​

Yes​

Yes​

·         FDA new release approval 10/23/25​

·         Centene PA effective 4/1/26​

J9999​

PERTUZUMAB-DPZB INJECTION​

POHERDY​

Yes​

Yes​

·         FDA new release approval 11/13/25​

·         Biosimilar to Perjeta-has PA​

·         Centene PA effective 4/1/26

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