Loading...Loading...Regence Medicare Advantage and its affiliated Plans use medical policies as guidelines for coverage decisions within the member’s written benefits. Below are summaries of recent changes to the Medicare Advantage medical policy manual. We have included the section and policy number for your convenience.
The complete Medicare Medical Policy Manual with detailed policies are available online at regence.com/provider/library/policies-guidelines/ma-medical-policy.
Policy name | Summary of policy or change | Effective date | Section and policy number |
|---|---|---|---|
Added additional guidance for wheelchair accessories. | February 1, 2025 | Durable Medical Equipment #M-37 | |
New policy addresses the use of ablation of peripheral nerves to treat pain. | February 1, 2025 | Surgery #M-236 | |
Updated policy to address concurrent optical and electromagnetic stimulation for wound healing. | January 1, 2025 | Durable Medical Equipment #M-83 | |
Updated the policy in alignment with the 2025 Q1 annual code update and latest Medicare guidance. | January 1, 2025 | Genetic Testing #M-64 | |
Updated the policy in alignment with the 2025 Q1 annual code update and latest Medicare guidance. | January 1, 2025 | Genetic Testing #M-83 | |
Updated the policy in alignment with the 2025 Q1 annual code update. | January 1, 2025 | Medicine #M-149 | |
| January 1, 2025 | Surgery #M-235 | |
New policy addresses screening laboratory testing in asymptomatic individuals. | December 1, 2024 | Laboratory #M-80 | |
NCD 110.23 criteria for allogeneic HSCT for myelodysplastic syndrome (MDS) has been expanded. | December 1, 2024 | Transplant #M-45 | |
Updated policy to remove retired Medicare guidance and add new billing and coding guidance. | November 1, 2024 | Durable Medical Equipment #M-78 | |
Updated policy to address only dual chamber leadless pacemakers. | November 1, 2024 | Surgery #M-217 | |
Expanded policy scope to include external lower extremity nerve stimulation for the treatment of restless leg syndrome. | October 1, 2024 | Durable Medical Equipment #M-83 | |
New Medicare policy to address lower extremity sensory prostheses. | October 1, 2024 | Durable Medical Equipment #M-95 | |
New policy to address amplitude-modulated radiofrequency electromagnetic fields (AM RF-EMF) for cancer treatment. | October 1, 2024 | Durable Medical Equipment #M-96 | |
| October 1, 2024 | Genetic Testing #M-64 | |
| October 1, 2024 | Genetic Testing #M-83 | |
New policy to address digital therapeutic products for gait training. | October 1, 2024 | Medicine #M-175.06 | |
Indicated that if no Medicare guidance is available, providers should refer to our commercial policy. | August 1, 2024 | Surgery #M-221 | |
Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Uncontrolled Hypertension | August 1, 2024 | Surgery #M-235 | |
Updated policy to address stimulation for nerve regeneration. | July 1, 2024 | Durable Medical Equipment #M-83 | |
Added five new CPT codes to policy and updated Medicare guidance. | July 1, 2024 | Genetic Testing #M-64 | |
Added several new tests and CPT codes to policy, with Medicare guidance when available. | July 1, 2024 | Genetic Testing #M-83 | |
Added codes related to 2024 Q3 code set update. | July 1, 2024 | Medicine #M-148 | |
Added codes related to 2024 Q3 code set update. | July 1, 2024 | Medicine #M-149 | |
Changed policy title from: Transurethral Water Vapor Thermal Therapy and Transurethral Water Jet Ablation (Aquablation) of the Prostate | July 1, 2024 | Surgery #M-210 | |
Policy name | Archive date | Medicare Manual section and policy # |
|---|---|---|
Radioembolization, Transarterial Embolization (TAE), and Transarterial Chemoembolization (TACE) | November 1, 2024 | Medicine #M-140 |