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Medicaid Medical Policy Archive Search



Name
Type
State
Effective
Bariatric Surgery Medical Policy PA Medicaid 08/01/18
Bariatric Surgery Medical Policy PA Medicaid 04/15/18
Bariatric Surgery Medical Policy PA Medicaid 07/05/16
BCR-ABL1 Genetic Testing in Leukemia Medical Policy PA Medicaid 10/01/16
BRAF Medical Policy PA Medicaid 12/01/17
BRCA1 & BRCA2 Genetic Testing Medical Policy PA Medicaid 08/01/16
Bronchial Thermoplasty Medical Policy PA Medicaid 07/19/17
Capsule Endoscopy Medical Policy PA Medicaid 05/01/17
Capsule Endoscopy Medical Policy PA Medicaid 03/01/17
Cardiac Rehabilitation Medical Policy PA Medicaid 09/15/17
Carpal Tunnel Syndrome Medical Policy PA Medicaid 07/19/2017
Chromosomal Microarray Analysis Medical Policy PA Medicaid 10/01/16
Colorectal Cancer Screening Medical Policy PA Medicaid 04/15/18
Colorectal Cancer Screening Medical Policy PA Medicaid 08/01/17
Continuous Glucose Monitoring Medical Policy PA Medicaid 09/15/17
Continuous Glucose Monitoring Medical Policy PA Medicaid 05/01/17
Custom-Made Oral Appliances in the Treatment of Obstructive Sleep Apnea(OSA) Medical Policy PA Medicaid 05/01/17
Enteral Feeding In-line Cartridge Medical Policy PA Medicaid 07/19/17
Fecal Microbiota Transplant Medical Policy PA Medicaid 02/15/18
Fetal Aneuploidy Medical Policy PA Medicaid 08/15/17
Fetal Aneuploidy Medical Policy PA Medicaid 07/16/16
G-CSF Drug
Policy		 PA Medicaid 09/15/17
Gender Transition Services Medical Policy PA Medicaid 12/01/16
Genetic Testing for Cystic Fibrosis Medical Policy PA Medicaid 04/14/16
Genetic Testing for Warfarin Medical Policy PA Medicaid 12/01/17
Home Oxygen Therapy (HOT) Medical Policy PA Medicaid 12/01/17
Hyperbaric Oxygen Therapy (HBOT) Medical Policy PA Medicaid 02/15/18
Hyperbaric Oxygen Therapy (HBOT) Medical Policy PA Medicaid 07/05/2016
Implantable Cardioverter-Defibrillator/ Subcutaneous Implantable Cardioverter-Defibrillator Medical Policy PA Medicaid 04/15/18
Implantable Cardioverter-Defibrillator/ Subcutaneous Implantable Cardioverter-Defibrillator Medical Policy PA Medicaid 07/19/17
Interleukin-5 Inhibitors Drug
Policy		 PA Medicaid 12/01/17
Interleukin-5 Inhibitors Drug
Policy		 PA Medicaid 12/01/16
Macular Degeneration Medical Policy PA Medicaid 10/01/17
Molecular Markers for Fine Needle Aspirates of Thyroid Nodules Medical Policy PA Medicaid 12/01/17
Negative Pressure Wound Therapy in the Outpatient Setting Medical Policy PA Medicaid 12/01/16
Noninvasive Assessment of Liver Fibrosis in Chronic Hepatitis C Medical Policy PA Medicaid 04/15/18
Noninvasive Assessment of Liver Fibrosis in Chronic Hepatitis C Medical Policy PA Medicaid 06/02/16
Noninvasive Positive Pressure Intermittent Ventilation (NPPV) Medical Policy PA Medicaid 04/15/18
Noninvasive Positive Pressure Intermittent Ventilation (NPPV) Medical Policy PA Medicaid 07/05/16
Non-oncologic genetic testing panels Medical Policy PA Medicaid 11/15/18
Ocrevus Drug
Policy		 PA Medicaid 08/01/17
Oncotype DX Medical Policy PA Medicaid 04/15/18
Oncotype DX Medical Policy PA Medicaid 07/05/16
Panniculectomy Medical Policy PA Medicaid 05/01/17
Passive Oscillatory Devices in the Outpatient Setting Medical Policy PA Medicaid 12/01/16
Place of Service Medical Policy PA Medicaid 10/01/17
Place of Service Medical Policy PA Medicaid 06/15/16
Pulmonary Rehabilitation Medical Policy PA Medicaid 09/15/17
Reconstructive Breast Surgery Medical Policy PA Medicaid 07/19/17
Skin Replacement Therapy for Chronic Non-healing Wounds in the Outpatient Setting Medical Policy PA Medicaid 05/01/2017
Soliris Drug
Policy		 PA Medicaid 07/01/16
Wearable Cardioverter-Defibrillator in Home Setting Medical Policy PA Medicaid 02/15/18
Wearable Cardioverter-Defibrillator in Home Setting Medical Policy PA Medicaid 04/20/2016
Whole Exome and Whole Genome Genetic Testing Medical Policy PA Medicaid 06/01/2016