Phototherapy for the Treatment of Seasonal Affective Disorder  

Effective 1 de julio de 2023, HCPCS code A4634 (replacement bulb for therapeutic light box, tabletop model) will change from not medically necessary for commercial products and not covered for Medicare Advantage plans to not reimbursable for commercial products and Medicare Advantage plans. For additional details and full review of this policy, please click here.  

EKG During Preventive Visit

We have updated the above policy to clarify which diagnoses will not be separately reimbursed when CPT code 93000 is filed with a preventive E/M visit. For additional details and full review of this policy, please click here.

Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions                                               

Effective 1 de julio de 2023, this policy will be archived; however, prior authorization will continue to be required for Medicare Advantage Plans and recommended for Commercial products and will be obtained utilizing the medical necessity criteria in the online tool for participating providers for both Medicare Advantage Plans and Commercial Products within the Prior Authorization via Web-Based Tool for Procedures.