Curative medical and medical drug policies
Curative medical policies:
- Ablative Procedures for Prostate Cancer Policy
- Actinic Keratoses Treatments Policy
- Acupuncture Policy
- ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP) Policy
- Ambulatory Assist Devices, Walkers, Canes and Crutches Policy
- Appropriate Level of Care - Short Stay and Observation Policy
- Bariatric Surgery Policy and Procedure
- Bathroom and Toilet Equipment and Supplies Policy
- Behavioral Health and Substance Use Disorder Services Policy - Members Under 18 (Birth through Age 17)
- Behavioral Health and Substance Use Disorder Services Policy - Members 18 and Over
- Benign Skin Lesion Removal Policy
- Breast Reconstructive Surgery Policy
- Breast Reduction Surgery and Gynecomastia Surgery Policy
- Capsule Endoscopy Policy
- Cardiac Event Monitors Policy
- Chiropractic Services Policy
- Colonoscopy and Colorectal Screening Policy
- Colony Stimulating Factors (CSF) Policy
- Electroconvulsive Therapy (ECT) Policy
- Experimental, Investigational & Emerging Technology
- External Breast Prosthesis Policy
- Eyelid Surgery Policy
- Glucose Monitoring Policy
- Hearing Aids Policy
- Heart Transplant Policy
- Home Health Skilled Nursing Services Policy
- Home Infusion Therapy Policy and Procedure
- Home Oxygen Policy
- Infertility Policy and Procedure
- Inpatient Section A — Medical & Acute Admissions Policy
- Inpatient Section B — NICU: Neonatal Intensive Care Policy
- Inpatient Section C — Oncology: Inpatient Cancer Treatment Policy
- Inpatient Section D — Surgical Procedures Policy
- Inpatient Section E — Gene Therapy Policy
- Inpatient Section F — Organ Transplant & Supplemental Policy
- Inpatient Section G — Other Inpatient Surgical Procedures Policy
- Invasive Back Pain Treatments Policy
- Kidney Transplant Policy
- Liver Transplant Policy
- Magnetic Resonance Imaging (MRI) Steerage Pilot Policy
- Non-Invasive Back Pain Treatment Policy
- Occupational Therapy Policy
- Panniculectomy and Redundant Skin Removal Policy and Procedure
- Physical Therapy Policy
- Post-Acute Care Policies
- Retrospective Authorization Policy
- Radiation Therapy Policy
- Site of Service Policy
- Sleep Apnea Policy
- Spinal Surgery - Laminectomy and Fusion Policy
- Transgender Affirmation Policy and Procedure
- Urinary Incontinence Policy
- Urological Supplies Policy
- Ventricular Assist Device Policy
- Virtual Gastrointestinal Endoscopy (CT Colonography) Policy
- Voice Therapy Policy
- Wheelchairs and Powered Operated Vehicles (Scooters) Policy
- Whole Genome Sequencing for Diagnosis of Constitutional (Germline) Disorders Policy
Curative medical drug policies
- Abatacept (Orencia) Policy
- Alpha 1-Proteinase Inhibitors Policy
- Benlysta Policy
- Botulinum Toxin Medical Policy
- Erythropoietins Prior Authorization Policy
- HIV Injectables Medical Policy
- Immunoglobulins Policy
- Intravenous Iron Medical Policy
- Multiple Sclerosis Policy
- Ozurdex Medical Policy
- Photosensitizing Topical Agents Medical Policy
- Spravato Medical Policy
- Testosterone Replacement Therapy Medical Policy
- Vascular Endothelial Growth Factor (VEGF) Inhibitors for Ocular Indications Medical Policy
- Vyepti Medical Policy
- Viscosupplementation Medical Policy
- Ycanth Medical Policy
- Zilretta Medical Policy
Archive
Applied Behavior Analysis (ABA) Therapy Policy - Archived 4/27/2026