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Medicaid Medical Policy Search



All drug policies are housed on the Medication Policy webpage. View all drug policies/criteria here.



Name
Type
State
Effective
Ambulatory Blood Pressure Monitors Medical PolicyPA Medicaid07/15/2018
Bariatric Surgery Medical PolicyPA Medicaid08/01/2018
BCR-ABL1 Genetic Testing in Leukemia Medical PolicyPA Medicaid03/18/2019
BRAF Medical PolicyPA Medicaid10/01/2018
BRCA1 & BRCA2 Genetic Testing Medical PolicyPA Medicaid03/18/2019
Bronchial Thermoplasty Medical PolicyPA Medicaid03/18/2019
Capsule Endoscopy Medical PolicyPA Medicaid03/18/2019
Cardiac Rehabilitation Medical PolicyPA Medicaid09/01/2018
Carpal Tunnel Syndrome Medical PolicyPA Medicaid09/01/2018
Chromosomal Microarray Analysis Medical PolicyPA Medicaid04/15/2018
Cochlear Implants Medical PolicyPA Medicaid06/01/2018
Colorectal Cancer Screening Medical PolicyPA Medicaid08/01/2018
Continuous Glucose Monitoring Medical PolicyPA Medicaid03/18/2019
Custom-Made Oral Appliances in the Treatment of Obstructive Sleep Apnea (OSA) Medical PolicyPA Medicaid03/18/2019
Electrical Bone Growth Stimulators for the Spine Medical PolicyPA Medicaid04/15/2018
Enteral Feeding In-line Cartridge Medical PolicyPA Medicaid09/01/2018
Esophagogastroduodenoscopy (EGD) Medical PolicyPA Medicaid08/01/2018
Fecal Microbiota Transplant Medical PolicyPA Medicaid11/15/2018
Fetal Aneuploidy Medical PolicyPA Medicaid09/15/2018
Gender Transition Services Medical PolicyPA Medicaid09/01/2018
Genetic Testing for Colorectal Cancer Susceptibility Medical PolicyPA Medicaid11/15/2018
Genetic Testing for Cystic Fibrosis Medical PolicyPA Medicaid01/15/2019
Genetic Testing for Warfarin Medical PolicyPA Medicaid09/15/2018
Home Oxygen Therapy (HOT) Medical PolicyPA Medicaid12/15/2018
Hyperbaric Oxygen Therapy (HBOT) Medical PolicyPA Medicaid12/15/2018
Hypoglossal Nerve Stimulator Medical PolicyPA Medicaid03/18/2019
Implantable Cardioverter-Defibrillator/ Subcutaneous Implantable Cardioverter-Defibrillator Medical PolicyPA Medicaid03/18/2019
Macular Degeneration Medical PolicyPA Medicaid09/15/2018
Molecular Markers for Fine Needle Aspirates of Thyroid Nodules Medical PolicyPA Medicaid10/01/2018
Molecular Testing in Lung Cancer Medical PolicyPA Medicaid09/15/2018
Molecular Tumor Markers NSCLC Medical PolicyPA Medicaid12/01/2017
Myoelectric Upper Extremity Orthoses Medical PolicyPA Medicaid02/18/2019
Negative Pressure Wound Therapy in the Outpatient Setting Medical PolicyPA Medicaid03/18/2019
Non-Oncologic Genetic Testing Panels Medical PolicyPA Medicaid12/15/2018
Noninvasive Assessment of Liver Fibrosis in Chronic Hepatitis C Medical PolicyPA Medicaid01/15/2019
Noninvasive Electrical Bone Growth Stimulators Medical PolicyPA Medicaid01/15/2019
Noninvasive Positive Pressure Intermittent Ventilation (NPPV) Medical PolicyPA Medicaid12/15/2018
Oncologic Genetic Testing Panels Medical PolicyPA Medicaid12/15/2018
Oncotype DX Medical PolicyPA Medicaid12/15/2018
Panniculectomy Medical PolicyPA Medicaid03/18/2019
Passive Oscillatory Devices in the Outpatient Setting Medical PolicyPA Medicaid01/15/2019
Place of Service Medical PolicyPA Medicaid11/15/2018
Pulmonary Rehabilitation Medical PolicyPA Medicaid07/15/2018
Reconstructive Breast Surgery Medical PolicyPA Medicaid09/01/2018
Supervised Exercise Therapy (SET) Medical PolicyPA Medicaid03/18/2019
Single Use ECG Monitoring (ZIO Patch) Medical PolicyPA Medicaid01/15/2019
Skin Replacement Therapy for Chronic Non-healing Wounds in the Outpatient Setting Medical PolicyPA Medicaid03/18/2019
Testing for Genetic Disease Medical PolicyPA Medicaid01/15/2019
Ultrasound Bone Growth Stimulator Medical PolicyPA Medicaid03/18/2019
Wearable Cardioverter-Defibrillators in the Home Setting Medical PolicyPA Medicaid12/15/2018
Whole Exome and Whole Genome Genetic Testing Medical PolicyPA Medicaid03/18/2019