Payer Policy Changes for Billing Teams

Policy	Payer	Type	Specialty	Date
Positron Emission Tomography (PET) Scans - RETIRED \| CMS Coverage Update	CMS	Modified	Radiology & Imaging	Jun 12, 2026
Surgical Treatments for Obstructive Sleep Apnea - (0158) \| CIGNA Coverage Update	CIGNA	Modified	Pulmonology	Jun 10, 2026
Otoplasty and External Ear Reconstruction - (0335) \| CIGNA Coverage Update	CIGNA	Modified	ENT / Otolaryngology	Jun 10, 2026
Vitamin D Testing - (0526) \| CIGNA Coverage Update	CIGNA	Modified	Laboratory	Jun 10, 2026
Panniculectomy and Abdominoplasty - (0027) \| CIGNA Coverage Update	CIGNA	Modified	General Surgery	Jun 9, 2026
Nucleic Acid Pathogen Testing - (0530) \| CIGNA Coverage Update	CIGNA	Modified	Laboratory	Jun 7, 2026
Scar Revision - (0328) \| CIGNA Coverage Update	CIGNA	Modified	Dermatology	Jun 6, 2026
Transcatheter Tricuspid Valve Replacement (TTVR) \| CMS Coverage Update	CMS	Modified	Cardiology	Jun 3, 2026
Transcatheter Edge-to-Edge Repair for Tricuspid Valve Regurgitation (T-TEER) \| CMS Coverage Update	CMS	Modified	Cardiology	Jun 3, 2026
Spine Procedures – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Orthopedics & Spine	Jun 3, 2026
Cosmetic and Reconstructive Procedures – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Dermatology	Jun 2, 2026
Durable Medical Equipment (DME), Prosthetics, Orthotics (Non-Foot Orthotics), Nutritional Therapy, and Medical Supplies Grid – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Physical Medicine & Rehab, Podiatry, DME & Home Health	Jun 2, 2026
Experimental Procedures and Items, Investigational Devices, and Clinical Trials – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	General / Multi-Specialty	Jun 2, 2026
Gastroesophageal and Gastrointestinal (GI) Services and Procedures – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Gastroenterology	Jun 2, 2026
Gender Dysphoria and Gender Reassignment Surgery – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Behavioral Health	Jun 2, 2026
Hospital, Emergency, and Ambulance Services – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	DME & Home Health	Jun 2, 2026
Medications/Drugs (Outpatient/Part B) – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Pharmacy	Jun 2, 2026
Molecular Pathology/Molecular Diagnostics/Genetic Testing – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Laboratory	Jun 2, 2026
Omnibus Codes – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	General / Multi-Specialty	Jun 2, 2026
Prostate Services and Procedures and Impotence Treatment – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Urology & Nephrology	Jun 2, 2026
Skin Substitutes Grafts/Cellular and Tissue-Based Products (Injections and/or Applications) – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Dermatology	Jun 2, 2026
Lung Cancer Screening with Low Dose Computed Tomography (LDCT) \| CMS Coverage Update	CMS	Modified	Oncology, Radiology & Imaging, Pulmonology, Primary Care	May 30, 2026
Noninvasive Positive Pressure Ventilation (NIPPV) in the Home for the Treatment of Chronic Respiratory Failure (CRF) Consequent to Chronic Obstructive Pulmonary Disease (COPD) \| CMS Coverage Update	CMS	Modified	Pulmonology	May 30, 2026
Cardiac Contractility Modulation (CCM) for Heart Failure (HF) \| CMS Coverage Update	CMS	Modified	Cardiology	May 30, 2026
Donor Lymphocyte Infusion and Hematopoietic Progenitor Cell HPC Boost - (0261) \| CIGNA Coverage Update	CIGNA	Modified	Hematology	May 16, 2026

Payer policy changesfor billing and compliance teams.

One missed policy change can cost thousands in denied claims.

Payer policy changes
for billing and compliance teams.