Priority Health medical policies

Medical policies apply to commercial plans and Medicaid. Medicare plans must follow Medicare policy under National Coverage Determinations and/or Local Coverage Determinations; if there are none, our medical policy will apply.

InterQual® criteria

Priority Health has discontinued some medical policies and now uses InterQual® criteria. For more information on InterQual® criteria see The Priority Health Utilization Management Program page.

Pending policy changes list

Review upcoming changes to our medical policies.

Current medical policies  

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    Knee Arthroscopy - 91587 Retired 06/2017

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Note: "CPT" (Current Procedure Terminology) is a registered trademark of the American Medical Association, U.S. Patent & Trademark Office Serial #76379850. The CPT Coding Manual itself is also copyrighted, U.S. Copyright Office Serial # CSN0096041. As a result, we have included the following disclaimer on our medical policies: All Current Procedure Terminology CPT) codes, descriptions, and other data are copyrighted by the American Medical Association.