Ambulatory Blood Pressure Monitors | Medical Policy | PA Medicaid | 09/16/2019 |
Bariatric Surgery |
Medical Policy | PA Medicaid |
05/06/2019 |
BCR-ABL1 Genetic Testing in Leukemia | Medical Policy | PA Medicaid | 03/16/2020 |
BRAF | Medical Policy | PA Medicaid | 10/21/2019 |
BRCA1 & BRCA2 Genetic Testing | Medical Policy | PA Medicaid |
06/17/2019 |
Bronchial Thermoplasty | Medical Policy | PA Medicaid | 03/16/2020 |
Capsule Endoscopy | Medical Policy | PA Medicaid | 03/16/2020 |
Carpal Tunnel Syndrome | Medical Policy | PA Medicaid |
06/17/2019 |
Chromosomal Microarray Analysis |
Medical Policy | PA Medicaid |
03/16/2020 |
Cochlear Implants |
Medical Policy | PA Medicaid |
05/06/2019 |
Colorectal Cancer Screening |
Medical Policy | PA Medicaid |
04/13/2020 |
Continuous Glucose Monitoring | Medical Policy | PA Medicaid |
06/17/2019 |
Custom-Made Oral Appliances in the Treatment of Obstructive Sleep Apnea (OSA) |
Medical Policy | PA Medicaid | 09/16/2019 |
Electrical Bone Growth Stimulators for the Spine |
Medical Policy | PA Medicaid |
05/06/2019 |
Enteral Feeding In-line Cartridge | Medical Policy | PA Medicaid | 07/15/2019 |
Fetal Aneuploidy | Medical Policy | PA Medicaid | 08/12/2019 |
Gender Transition Services |
Medical Policy | PA Medicaid |
05/06/2019 |
Genetic Testing for Cystic Fibrosis | Medical Policy | PA Medicaid | 01/20/2020 |
Genetic Testing for Warfarin | Medical Policy | PA Medicaid | 08/12/2019 |
Home Oxygen Therapy (HOT) | Medical Policy | PA Medicaid | 10/21/2019 |
Hyperbaric Oxygen Therapy (HBOT) | Medical Policy | PA Medicaid | 12/09/2019 |
Hypoglossal Nerve Stimulator | Medical Policy | PA Medicaid | 03/16/2020 |
Implantable Cardioverter-Defibrillator/ Subcutaneous Implantable Cardioverter-Defibrillator | Medical Policy | PA Medicaid | 08/12/2019 |
Molecular Markers for Fine Needle Aspirates of Thyroid Nodules | Medical Policy | PA Medicaid | 10/21/2019 |
Molecular Tumor Markers for Non-Small Cell Lung Cancer (NSCLC) | Medical Policy | PA Medicaid | 09/16/2019 |
Myoelectric Upper Extremity Orthoses | Medical Policy | PA Medicaid | 02/17/2020 |
Negative Pressure Wound Therapy in the Outpatient Setting | Medical Policy | PA Medicaid | 03/16/2020 |
Noninvasive Electrical Bone Growth Stimulators | Medical Policy | PA Medicaid | 01/20/2020 |
Noninvasive Positive Pressure Intermittent Ventilation (NPPV) | Medical Policy | PA Medicaid | 01/20/2020 |
Oncotype DX | Medical Policy | PA Medicaid | 12/09/2019 |
Panniculectomy | Medical Policy | PA Medicaid | 03/16/2020 |
Passive Oscillatory Devices in the Outpatient Setting | Medical Policy | PA Medicaid | 01/20/2020 |
Place of Service | Medical Policy | PA Medicaid | 01/20/2020 |
Pulmonary Rehabilitation | Medical Policy | PA Medicaid |
04/13/2020 |
Supervised Exercise Therapy (SET) | Medical Policy | PA Medicaid | 02/17/2020 |
Single Use ECG Monitoring (ZIO Patch) | Medical Policy | PA Medicaid | 01/20/2020 |
Skin Replacement Therapy for Chronic Non-healing Wounds in the Outpatient Setting | Medical Policy | PA Medicaid |
03/16/2020 |
Testing for Genetic Disease | Medical Policy | PA Medicaid | 01/20/2020 |
Ultrasound Bone Growth Stimulator | Medical Policy | PA Medicaid | 03/16/2020 |
Wearable Cardioverter-Defibrillators in the Home Setting | Medical Policy | PA Medicaid | 11/18/2019 |
Whole Exome and Whole Genome Genetic Testing | Medical Policy | PA Medicaid | 03/16/2020 |
Ambulance – Ground | Medical Policy | PA Medicaid | 04/13/2020 |
Ambulance – Air | Medical Policy | PA Medicaid | 04/13/2020 |
MRgFUS | Medical Policy | PA Medicaid | 5/6/2019 |
Prostate Cancer Genetic Testing |
Medical Policy |
PA Medicaid |
12/09/2019 |
Upper Gastrointestinal Endoscopy | Medical Policy | PA Medicaid | 08/12/2019 |
Vitamin D Deficiency Testing | Medical Policy | PA Medicaid | 06/17/2019 |
Treatment of Obstructive Sleep Apnea | Medical Policy | PA Medicaid | 11/18/2019 |
Repetitive Transcranial Magnetic Stimulation | Medical Policy | PA Medicaid | 11/18/2019 |
Cosmetic Procedures |
Medical Policy |
PA Medicaid |
12/09/2019 |
Gastric Electrical Stimulation (GES) |
Medical Policy |
PA Medicaid |
12/09/2019 |
Bronchial Valves | Medical Policy | PA Medicaid | 12/09/2019 |
Exhaled Nitric Oxide Measurement in the Management of Respiratory Disorders | Medical Policy | PA Medicaid | 12/09/2019 |
Breast Scintimammography | Medical Policy | PA Medicaid | 01/20/2020 |
DXA for Vertebral Fracture Assessment | Medical Policy | PA Medicaid | 01/20/2020 |
Minimally Invasive Lumbar Decompression | Medical Policy | PA Medicaid | 3/16/2020 |
Prostatic Urethral Lift | Medical Policy | PA Medicaid | 3/16/2020 |
Multimarker Serum Testing for Ovarian Cancer | Medical Policy | PA Medicaid | 3/16/2020 |
Speech Generating Devices | Medical Policy | PA Medicaid | 3/16/2020 |
Bariatric Surgery |
Medical Policy | PA Medicaid |
05/18/2020 |
Electrical Bone Growth Stimulators for the Spine |
Medical Policy | PA Medicaid |
05/18/2020 |
Reconstructive Breast Surgery | Medical Policy | PA Medicaid |
06/17/2019 |
Cardiac Rehabilitation | Medical Policy | PA Medicaid | 07/15/2019 |
Artificial Pancreas | Medical Policy | PA Medicaid | 08/12/2019 |
Percutaneous Left Atrial Appendage Closure (LAAC) | Medical Policy | PA Medicaid | 08/12/2019 |
Deep Brain Stimulation | Medical Policy | PA Medicaid | 08/12/2019 |
Scanning Computerized Ophthalmic Imaging | Medical Policy | PA Medicaid | 07/15/2019 |
Fecal Microbiota Transplant | Medical Policy | PA Medicaid | 10/21/2019 |
Ambulance Services – Ground | Medical Policy | PA Medicaid | 4/13/2020 |
Non-Oncologic Genetic Testing Panels | Medical Policy | PA Medicaid | 11/18/2019 |
Oncologic Genetic Testing Panels | Medical Policy | PA Medicaid | 11/18/2019 |
Cosmetic Procedures |
Medical Policy |
PA Medicaid |
12/09/2019 |
Genetic Testing for Colorectal Cancer Susceptibility | Medical Policy | PA Medicaid | 11/18/2019 |
Bronchial Valves | Medical Policy | PA Medicaid | 12/09/2019 |
Genetic Testing for Cystic Fibrosis | Medical Policy | PA Medicaid | 05/18/2020 |
Electrical Stimulation for Oropharyngeal Dysphagia | Medical Policy | PA Medicaid | 11/18/2019 |
Noninvasive Positive Pressure Intermittent Ventilation (NPPV) | Medical Policy | PA Medicaid | 01/20/2020 |
Bariatric Surgery |
Medical Policy | PA Medicaid |
05/18/2020 |
Bronchial Thermoplasty | Medical Policy | PA Medicaid | 03/16/2020 |
Capsule Endoscopy | Medical Policy | PA Medicaid | 03/16/2020 |
Chromosomal Microarray Analysis |
Medical Policy | PA Medicaid |
03/16/2020 |
Colorectal Cancer Screening |
Medical Policy | PA Medicaid |
04/13/2020 |
Electrical Bone Growth Stimulators for the Spine |
Medical Policy | PA Medicaid |
05/18/2020 |
MRgFUS | Medical Policy | PA Medicaid | 5/18/2020 |
Pulmonary Rehabilitation | Medical Policy | PA Medicaid |
04/13/2020 |
Speech Generating Devices | Medical Policy | PA Medicaid | 3/16/2020 |
Single Use ECG Monitoring (ZIO Patch) | Medical Policy | PA Medicaid | 12/21/2020 |
Gender Transition Services |
Medical Policy | PA Medicaid |
04/13/2020 |
Prescription Digital Therapeutics (e.g., reSET and reSET-O) |
Medical Policy |
PA Medicaid |
12/21/2020 |