Automated Ambulatory Blood Pressure Monitoring (ABPM) | Medical Policy | PA Medicaid | 09/07/2020 |
Bariatric Surgery |
Medical Policy | PA Medicaid |
05/18/2020 |
BCR-ABL1 Testing in Chronic Muelogenous Leukemia and Acute Lymphoblastic Leukemia | Medical Policy | PA Medicaid | 03/15/2021 |
BRAF Mutation Analysis | Medical Policy | PA Medicaid | 10/19/2020 |
BRCA1 & BRCA2 Genetic Testing | Medical Policy | PA Medicaid |
06/22/2020 |
Bronchial Thermoplasty | Medical Policy | PA Medicaid | 03/16/2020 |
Capsule Endoscopy | Medical Policy | PA Medicaid | 03/16/2020 |
Cardiac Rehabilitation | Medical Policy | PA Medicaid | 06/22/2020 |
Carpal Tunnel Syndrome | Medical Policy | PA Medicaid |
05/18/2020 |
Chromosomal Microarray Analysis |
Medical Policy | PA Medicaid |
03/16/2020 |
Cochlear Implants |
Medical Policy | PA Medicaid |
10/19/2020 |
Colorectal Cancer Screening |
Medical Policy | PA Medicaid |
04/13/2020 |
Custom-Made Oral Appliances in the Treatment of Obstructive Sleep Apnea (OSA) |
Medical Policy | PA Medicaid | 09/07/2020 |
Electrical Bone Growth Stimulators for the Spine |
Medical Policy | PA Medicaid |
05/18/2020 |
Enteral Feeding In-line Cartridge | Medical Policy | PA Medicaid | 06/22/2020 |
Fecal Microbiota Transplant | Medical Policy | PA Medicaid | 09/07/2020 |
Fetal Testing Using Noninvasive Cell-Free Fetal DNA Aneuploidy
| Medical Policy | PA Medicaid | 08/17/2020 |
Gender Transition Services |
Medical Policy | PA Medicaid |
04/13/2020 |
Genetic Testing for Lynch Syndrome, Familial Adenomatous Polyposis (FAP), Attenuated FAP and MYH-associated Polyposis | Medical Policy | PA Medicaid | 11/16/2020 |
Genetic Testing for Cystic Fibrosis | Medical Policy | PA Medicaid | 12/21/2020 |
Genetic Testing for Warfarin and Clopidogrel Therapy | Medical Policy | PA Medicaid | 08/17/2020 |
Home Oxygen Therapy (HOT) | Medical Policy | PA Medicaid | 09/07/2020 |
Hyperbaric Oxygen Therapy (HBOT) | Medical Policy | PA Medicaid | 11/16/2020 |
Hypoglossal Nerve Stimulation Implantation i n the Treatment of Obstructive Sleep Apnea | Medical Policy | PA Medicaid | 03/15/2021 |
Implantable Cardioverter-Defibrillator/ Subcutaneous Implantable Cardioverter-Defibrillator | Medical Policy | PA Medicaid | 08/12/2019 |
Macular Degeneration | Medical Policy | PA Medicaid | 08/12/2019 |
Molecular Markers for Fine Needle Aspirates of Thyroid Nodules | Medical Policy | PA Medicaid | 10/19/2020 |
Molecular Tumor Markers for Non-Small Cell Lung Cancer (NSCLC) | Medical Policy | PA Medicaid |
10/19/2020 |
Myoelectric Upper Extremity Orthoses | Medical Policy | PA Medicaid | 01/18/2021 |
Negative Pressure Wound Therapy in the Outpatient Setting | Medical Policy | PA Medicaid | 03/15/2021 |
Non-Oncologic Genetic Testing Panels | Medical Policy | PA Medicaid | 11/16/2020 |
Noninvasive Electrical Bone Growth Stimulators (Osteogenesis Stimulators)
| Medical Policy | PA Medicaid | 01/18/2021 |
Noninvasive Positive Pressure Intermittent Ventilation in the Home Setting | Medical Policy | PA Medicaid | 01/18/2021 |
Gene Expression Testing for Breast Cancer Treatment | Medical Policy | PA Medicaid | 12/21/2020 |
Panniculectomy/Abdominoplasty/Lipectomy | Medical Policy | PA Medicaid | 03/15/2021 |
Passive Oscillatory Devices in the Outpatient Setting | Medical Policy | PA Medicaid | 01/18/2021 |
Place of Service | Medical Policy | PA Medicaid | 10/19/2020 |
Pulmonary Rehabilitation | Medical Policy | PA Medicaid |
04/13/2020 |
Breast Reconstructive Surgery | Medical Policy | PA Medicaid |
06/22/2020 |
Supervised Exercise Therapy (SET) | Medical Policy | PA Medicaid | 12/21/2020 |
Single Use ECG Monitoring (ZIO Patch) | Medical Policy | PA Medicaid | 12/21/2020 |
Skin Replacement Therapy for Chronic Non-healing Wounds in the Outpatient Setting | Medical Policy | PA Medicaid |
03/15/2021 |
Testing for Genetic Disease | Medical Policy | PA Medicaid | 02/15/2021 |
Ultrasound Bone Growth Stimulator | Medical Policy | PA Medicaid | 03/15/2021 |
Wearable Cardioverter-Defibrillators in the Home Setting | Medical Policy | PA Medicaid | 01/18/2021 |
Whole Exome and Whole Genome Genetic Testing | Medical Policy | PA Medicaid | 03/15/2021 |
Ambulance Services – Ground | Medical Policy | PA Medicaid | 09/07/2020 |
MRgFUS | Medical Policy | PA Medicaid | 5/18/2020 |
Prostate Cancer Genetic Testing |
Medical Policy |
PA Medicaid |
12/21/2020 |
Upper Gastrointestinal Endoscopy (EGD-esophagogastroduodenoscopy) | Medical Policy | PA Medicaid | 10/19/2020 |
Vitamin D Deficiency Testing | Medical Policy | PA Medicaid |
10/19/2020 |
Scanning Computerized Ophthalmic Imaging | Medical Policy | PA Medicaid | 07/27/2020 |
Artificial Pancreas | Medical Policy | PA Medicaid | 07/27/2020 |
Percutaneous Left Atrial Appendage Closure (LAAC) | Medical Policy | PA Medicaid | 07/27/2020 |
Deep Brain Stimulation | Medical Policy | PA Medicaid | 07/27/2020 |
Treatment of Obstructive Sleep Apnea | Medical Policy | PA Medicaid | 11/16/2020 |
Electrical Stimulation for Oropharyngeal Dysphagia | Medical Policy | PA Medicaid | 01/18/2021 |
Repetitive Transcranial Magnetic Stimulation | Medical Policy | PA Medicaid | 11/18/2019 |
Oncologic Genetic Testing Panels | Medical Policy | PA Medicaid | 11/16/2020 |
Cosmetic Procedures |
Medical Policy |
PA Medicaid |
11/16/2020 |
Gastric Electrical Stimulation (GES) |
Medical Policy |
PA Medicaid |
12/21/2020 |
Bronchial Valves | Medical Policy | PA Medicaid | 12/21/2020 |
Exhaled Nitric Oxide Measurement in the Management of Respiratory Disorders | Medical Policy | PA Medicaid | 12/21/2020 |
Breast Scintimammography | Medical Policy | PA Medicaid | 12/21/2020 |
DXA for Vertebral Fracture Assessment | Medical Policy | PA Medicaid | 12/21/2020 |
Minimally Invasive Lumbar Decompression | Medical Policy | PA Medicaid | 03/15/2021 |
Prostatic Urethral Lift | Medical Policy | PA Medicaid | 03/15/2021 |
Multimarker Serum Testing for Ovarian Cancer | Medical Policy | PA Medicaid | 03/15/2021 |
Speech Generating Devices | Medical Policy | PA Medicaid | 3/16/2020 |
Labiaplasty |
Medical Policy |
PA Medicaid |
4/13/2020 |
Endoscopic Ultrasound (EUS) and Endoscopic Retrograde Cholangiopancreatography
(ERCP) |
Medical Policy |
PA Medicaid |
10/19/2020 |
Prescription Digital Therapeutics (e.g., reSET and reSET-O) |
Medical Policy |
PA Medicaid |
12/21/2020 |