Provider Policy Notifications
This page contains notifications for clinical policies that have future effective dates. For current policies, visit the Clinical Policies page.
Policies effective 9/1/2025
- Behavioral Health Treatment Documentation Requirements (PDF) (HIM.CP.BH.500)
- Cardiac Stents (PDF) (WA.CP.MP.513)
- Cochlear Implants (PDF) (WA.CP.MP.502)
- Microprocessor-Controlled Lower Limb Prosthetics (PDF) (WA.CP.MP.505)
- Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention (PDF) (CP.MP.147)
- Skin Substitutes for Chronic Wounds (PDF) (CP.MP.185)
- Transplant Service Documentation Requirements (PDF) (CP.MP.247)
Policies effective 10/1/2025
- Allogeneic Hematopoietic Progenitor Cell Therapy (PDF) (CP.MP.249)
- Drugs of Abuse: Definitive Testing (PDF) (CP.MP.50)
- Fecal Incontinence Treatments (PDF) (CP.MP.137)
- Heart-Lung Transplant (PDF) (CP.MP.132)
- Intestinal and Multivisceral Transplant (PDF) (CP.MP.58)
- Reduction Mammoplasty and Gynecomastia Surgery (PDF) (CP.MP.51)
- Therapeutic Utilization of Inhaled Nitric Oxide (PDF) (CP.MP.87)
- Transcranial Magnetic Stimulation (TMS) for TRMD (PDF) (CP.BH.200)
- Total Artificial Heart (PDF) (CP.MP.127)
- Vagus Nerve Stimulation (PDF) (WA.CP.MP.12)
- Varicose Vein Treatment (PDF) (WA.CP.MP.522)
Policies effective 9/1/2025
- Behavioral Health Treatment Documentation Requirements (PDF) (CP.BH.500)
- Cardiac Stents (PDF) (WA.CP.MP.513)
- Cochlear Implants (PDF) (WA.CP.MP.502)
- Microprocessor-Controlled Lower Limb Prosthetics (PDF) (WA.CP.MP.505)
- Skin Substitutes (PDF) (WA.CP.MP.185)
- Transplant Service Documentation Requirements (PDF) (CP.MP.247)
Policies effective 10/1/2025
- Allogeneic Hematopoietic Progenitor Cell Therapy (PDF) (CP.MP.249)
- Drugs of Abuse: Definitive Testing (PDF) (CP.MP.50)
- Fecal Incontinence Treatments (PDF) (CP.MP.137)
- Heart-Lung Transplant (PDF) (CP.MP.132)
- Intestinal and Multivisceral Transplant (PDF) (CP.MP.58)
- Reduction Mammoplasty and Gynecomastia Surgery (PDF) (CP.MP.51)
- Therapeutic Utilization of Inhaled Nitric Oxide (PDF) (CP.MP.87)
- Total Artificial Heart (PDF) (CP.MP.127)
- Transcranial Magnetic Stimulation (TMS) for TRMD (PDF) (WA.CP.BH.200)
- Vagus Nerve Stimulation (PDF) (WA.CP.MP.12)
- Varicose Vein Treatment (PDF) (WA.CP.MP.522)