We publish billing policies to offer transparency and help providers to bill claims more accurately to reduce delays in processing claims, as well as avoid rebilling and additional requests for information.
The following billing policies were recently published to or updated in our Provider Manual.
Be sure to review carefully. Some policy updates will be effective Dec. 14, 2026, due to new requirements or changes that may impact how you work with us.
All other policies represent our current system set up and/or expectations for transparency. There are either no changes for providers as the policy is already in effect or the policy was recently shared with the network and we’re implementing a clinical edit in alignment with the policy’s language.
| Billing policy | Description | Effective date |
|---|---|---|
| New policies | ||
| Chest X-Rays and ACR Appropriateness Criteria - #212 |
| N/A |
| Extracorporeal Photopheresis - #211 | ||
| Office Lab Policy #213 |
| Jan. 11, 2027 |
| Updated policies | ||
| Laboratory and Pathology - #015 |
| N/A |
| JW, JZ: Drug Dosing Modifiers - #188 |
| N/A |