A-G |
H-P |
Q-Z |
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Acupuncture (PDF)
Effective Date: 1/1/2022 |
H Pylori Testing (PDF)
Effective Date: 1/1/2022 |
Radial Head Implant (PDF)
Effective Date: 1/1/2022 |
ADHD Assessment and Treatment (PDF)
Effective Date: 1/1/2022 |
Heart-Lung Transplant (PDF)
Effective Date: 1/1/2022 |
Radiofrequency Ablation of Uterine Fibroids (PDF)
Effective Date: 1/1/2022 |
Air Ambulance (PDF)
Effective Date: 1/1/2022 |
Holter Monitors (PDF)
Effective Date: 1/1/2022 |
Reduction Mammoplasty and Gynecomastia Surgery (PDF)
Effective Date: 1/1/2022 |
Allergy Testing (PDF)
Effective Date: 1/1/2022 |
Home Birth (PDF)
Effective Date: 1/1/2022 |
Repair of Nasal Valve Compromise (PDF)
Effective Date: 1/1/2022 |
Allogeneic Hematopoietic Cell Transplants for Sickle Cell Anemia and Beta-Thalassemia (PDF)
Effective Date: 1/1/2022 |
Home phototherapy for neonatal hyperbilirubinemia (PDF)
Effective Date: 1/1/2022 |
Sacroiliac Joint Fusion (PDF)
Effective Date: 1/1/2022 |
Ambulatory Surgery Center Optimization (PDF)
Effective Date: 1/1/2022 |
Homocysteine Testing (PDF)
Effective Date: 1/1/2022 |
Sacroiliac Joint Interventions for Pain Management (PDF)
Effective Date: 1/1/2022 |
Articular Cartilage Defect Repairs (PDF)
Effective Date: 1/1/2022
|
Hospice Services (PDF)
Effective Date: 1/1/2022
|
Scanning computerized Ophthalmic Diagnostic Imaging (SCODI) (PDF)
Effective Date: 1/1/2022
|
Assisted Reproductive Technology (PDF)
Effective Date: 1/1/2022 |
Hyperemesis gravidarum treatment (PDF)
Effective Date: 1/1/2022
|
Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins (PDF)
Effective Date: 1/1/2022
|
Bariatric Surgery (PDF)
Effective Date: 1/1/2022
|
Hyperhidrosis treatments (PDF)
Effective Date: 1/1/2022
|
Selective Dorsal Rhizotomy (PDF)
Effective Date: 1/1/2022
|
Biofeedback (PDF)
Effective Date: 1/1/2022
|
Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (PDF)
Effective Date: 1/1/2022
|
Selective Nerve Root Blocks and Transforaminal Epidural Injections (PDF)
Effective Date: 1/1/2022
|
Bone-anchored hearing aid (PDF)
Effective Date: 1/1/2022 |
Implantable Intrathecal Pain Pump (PDF)
Effective Date: 1/1/2022
|
Short Inpatient Hospital Stay (PDF)
Effective Date: 1/1/2022
|
Bronchial Thermoplasty (PDF)
Effective Date: 1/1/2022 |
Implantable Loop Recorder (PDF)
Effective Date: 6/22/2022 |
Skilled Nursing Facility Leveling (PDF)
Effective Date: 1/1/2022
|
Burn Surgery (PDF)
Effective Date: 1/1/2022
|
Implantable Wireless Pulmonary Artery Pressure Monitoring (PDF)
Effective Date: 1/1/2022 |
Skin Substitutes for Chronic Wounds (PDF)
Effective Date: 1/1/2022
|
Cardiac Biomarker Testing for Acute MI (PDF)
Effective Date: 1/1/2022
|
Inhaled nitric oxide (PDF)
Effective Date: 1/1/2022 |
Spinal Cord Stimulation (PDF)
Effective Date: 1/1/2022
|
Caudal or Interlaminar Epidural Steroid Injections (PDF)
Effective Date: 1/1/2022
|
Intensity-Modulated Radiotherapy (PDF)
Effective Date: 1/1/2022 |
Stereotactic Body Radiation Therapy (PDF)
Effective Date: 1/1/2022
|
Clinical Trials (PDF)
Effective Date: 1/1/2022
|
Intestinal and Multivisceral Transplant (PDF)
Effective Date: 1/1/2022 |
Tandem Transplant (PDF)
Effective Date: 1/1/2022
|
Cochlear Implant Replacements (PDF)
Effective Date: 1/1/2022
|
Intradiscal Steroid Injections for Pain Management (PDF)
Effective Date: 1/1/2022 |
Testing for Select Genitourinary Conditions (previously Diagnosis of Vaginitis) (PDF)
Effective Date: 1/1/2022
|
Cosmetic and Reconstructive Surgery (PDF)
Effective Date: 1/1/2022
|
Laser Skin Treatment (PDF)
Effective Date: 1/1/2022 |
Thyroid Testing in Pediatrics (PDF)
Effective Date: 1/1/2022
|
Dental Anesthesia (PDF)
Effective Date: 1/1/2022 |
Long Term Care Placement Criteria (PDF)
Effective Date: 1/1/2022
|
Total Artificial Heart (PDF)
Effective Date: 1/1/2022
|
Diaphragmatic/Phrenic Nerve Stimulation (PDF)
Effective Date: 1/1/2022
|
Low-Frequency Ultrasound Wound Therapy (PDF)
Effective Date: 1/1/2022 |
Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (PDF)
Effective Date: 1/1/2022
|
Digital EEG Analysis (PDF)
Effective Date: 1/1/2022
|
Lung Transplantation (PDF)
Effective Date: 1/1/2022
|
Transcatheter Closure of Patent Foramen Ovale (PDF)
Effective Date: 1/1/2022 |
Disc Decompression Procedures (PDF)
Effective Date: 1/1/2022
|
Lysis of Epidural Lesions (PDF)
Effective Date: 1/1/2022
|
Trigger Point Injections for Pain Management (PDF)
Effective Date: 1/1/2022
|
Discography (PDF)
Effective Date: 1/1/2022
|
Measure Serum 1,25 Vitamin D (PDF)
Effective Date: 1/1/2022 |
Ultrasound in Pregnancy (PDF)
Effective Date: 1/1/2022
|
Donor lymphocyte infusion (PDF)
Effective Date: 1/1/2022
|
Mechanical Stretching Devices for Joint Stiffness and Contracture (PDF)
Effective Date: 1/1/2022
|
Urinary Incontinence Devices and Treatments (PDF)
Effective Date: 1/1/2022
|
Drugs of Abuse: Definitive Testing (previously Outpatient Testing for Drugs of Abuse) (PDF)
Effective Date: 1/1/2022
|
Multiple Sleep Latency Testing (PDF)
Effective Date: 1/1/2022
|
Urodynamic Testing (PDF)
Effective Date: 1/1/2022
|
Durable Medical Equipment (DME) (PDF)
Effective Date: 1/1/2022
|
Neonatal Abstinence Syndrome Guidelines (PDF)
Effective Date: 1/1/2022
|
Vagus Nerve Stimulation (PDF)
Effective Date: 1/1/2022
|
EEG in Evaluation of Headache (PDF)
Effective Date: 1/1/2022
|
Neonatal Sepsis Management (PDF)
Effective Date: 1/1/2022
|
Ventricular Assist Device (PDF)
Effective Date: 1/1/2022
|
Electric Tumor Treating Fields (PDF)
Effective Date: 1/1/2022
|
Nerve Blocks for Pain Management (PDF)
Effective Date: 1/1/2022
|
Vitamin D Testing in Children (PDF)
Effective Date: 1/1/2022
|
Endometrial Ablation (PDF)
Effective Date: 1/1/2022
|
Neuromuscular Electrical Stimulation (NMES) (PDF)
Effective Date: 1/1/2022
|
Wheelchair Seating (PDF)
Effective Date: 1/1/2022
|
Essure Removal (PDF)
Effective Date: 1/1/2022
|
NICU Apnea Bradycardia Guidelines (PDF)
Effective Date: 1/1/2022
|
Wireless Motility Capsule (PDF)
Effective Date: 1/1/2022 |
Evoked Potentials (PDF)
Effective Date: 1/1/2022
|
NICU Discharge Guidelines (PDF)
Effective Date: 1/1/2022
|
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Experimental Technologies (PDF)
Effective Date: 1/1/2022
|
Non-invasive Home Ventilators (PDF)
Effective Date: 1/1/2022 |
|
External Ocular Photography (PDF)
Effective Date: 1/1/2022 |
Non-myeloablative Allogeneic Stem Cell Transplants (PDF)
Effective Date: 1/1/2022 |
|
Facet Joint Interventions (PDF)
Effective Date: 1/1/2022
|
Obstetrical Home Health Care Programs (PDF)
Effective Date: 1/1/2022 |
|
Fecal incontinence treatments (PDF)
Effective Date: 1/1/2022
|
Optic Nerve Decompression Surgery (PDF)
Effective Date: 1/1/2022 |
|
Ferriscan R2-MRI (PDF)
Effective Date: 1/1/2022
|
Orthognathic Surgery (PDF)
Effective Date: 1/1/2022 |
|
Fertility preservation (PDF)
Effective Date: 1/1/2022
|
Osteogenic Stimulation (PDF)
Effective Date: 1/1/2022 |
|
Fetal surgery in utero for prenatally diagnosed malformations (PDF)
Effective Date: 1/1/2022
|
Outpatient Cardiac Rehabilitation (PDF)
Effective Date: 1/1/2022 |
|
Fluorescein Angiography (PDF)
Effective Date: 1/1/2022
|
Oxygen Use and Concentrators (PDF)
Effective Date: 1/1/2022 |
|
Fundus Photography (PDF)
Effective Date: 1/1/2022
|
Pancreas Transplant (PDF)
Effective Date: 1/1/2022 |
|
Functional MRI (PDF)
Effective Date: 1/1/2022
|
Panniculectomy (PDF)
Effective Date: 1/1/2022 |
|
Gastric Electrical Stimulation (PDF)
Effective Date: 1/1/2022
|
Pediatric Heart Transplant (PDF)
Effective Date: 1/1/2022 |
|
Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing (PDF)
Effective Date: 1/1/2022
|
Pediatric Liver Transplant (PDF)
Effective Date: 1/1/2022 |
|
Gender Affirming Procedures (PDF)
Effective Date: 1/1/2022
|
Pediatric Oral Function Therapy (PDF)
Effective Date: 1/1/2022 |
|
Gonioscopy (PDF)
Effective Date: 1/1/2022
|
Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention (PDF)
Effective Date: 1/1/2022 |
|
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Physical, Occupational, and Speech Therapy Services (PDF)
Effective Date: 1/1/2022 |
|
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Polymerase Chain Reaction Respiratory Viral Panel Testing (PDF)
Effective Date: 1/1/2022 |
|
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Post Acute Care (PDF)
Effective Date: 1/1/2022 |
|
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Posterior Tibial Nerve Stimulation for Voiding Dysfunction (PDF)
Effective Date: 1/1/2022
|
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Proton and Neutron Beam Therapies (PDF)
Effective Date: 1/1/2022
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