Medicare Retired Medical Policy Search

Name	Type	State	Effective
Fetal Aneuploidy	Medical Policy	KY Medicare	07/15/18
Fetal Aneuploidy	Medical Policy	OH Medicare	07/15/18
Fetal Aneuploidy	Medical Policy	KY Medicare	08/01/17
Fetal Aneuploidy	Medical Policy	OH Medicare	08/01/17
Fetal Aneuploidy	Medical Policy	PA Medicare	07/15/18
Fetal Aneuploidy	Medical Policy	NC Medicare	08/01/17
Fetal Aneuploidy	Medical Policy	PA Medicare	08/01/17
Genetic Testing for Colorectal Cancer Susceptibility	Medical Policy	KY Medicare	10/01/17
Genetic Testing for Colorectal Cancer Susceptibility	Medical Policy	NC Medicare	10/01/17
Genetic Testing for Colorectal Cancer Susceptibility	Medical Policy	OH Medicare	10/01/17
Genetic Testing for Colorectal Cancer Susceptibility	Medical Policy	PA Medicare	10/01/17
Perjeta	Medical Policy	KY Medicare	09/15/18
Perjeta	Medical Policy	OH Medicare	09/15/18
Perjeta	Drug Policy	KY Medicare	05/01/17
Perjeta	Drug Policy	OH Medicare	05/01/17
Testing for Genetic Disease	Medical Policy	KY Medicare	11/15/18
Testing for Genetic Disease	Medical Policy	NC Medicare	11/15/18
Testing for Genetic Disease	Medical Policy	OH Medicare	11/15/18
Testing of Genetic Disease	Medical Policy	KY Medicare	12/01/17
Testing of Genetic Disease	Medical Policy	NC Medicare	12/01/17
Testing of Genetic Disease	Medical Policy	OH Medicare	12/01/17
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Medical Policy	KY Medicare	11/15/18
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Medical Policy	NC Medicare	11/15/18
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Medical Policy	PA Medicare	11/15/18
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Medical Policy	OH Medicare	11/15/18
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Medical Policy	KY Medicare	10/01/17
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Medical Policy	NC Medicare	10/01/17
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Medical Policy	OH Medicare	10/01/17
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Medical Policy	PA Medicare	10/01/17
Velcade	Drug Policy	OH Medicare	01/15/2019
G-CSF	Drug Policy	KY Medicare	01/15/2019
Interleukin-5 Inhibitors	Drug Policy	KY Medicare	01/15/2019
Velcade	Drug Policy	KY Medicare	01/15/2019
Home Oxygen Therapy	Medical Policy	KY Medicare	01/15/2019
Brineura	Drug Policy	KY Medicare	02/18/2019
Fecal Transplant	Medical Policy	KY Medicare	02/18/2019
Self-contained Cardiac Pacemakers	Medical Policy	KY Medicare	05/06/2019
Transtelephonic Monitoring	Medical Policy	KY Medicare	05/06/2019
Automatic External Defibrillators	Medical Policy	KY Medicare	05/06/2019
Electrocardiographic Services	Medical Policy	KY Medicare	05/06/2019
Electrical Nerve Stimulator	Medical Policy	KY Medicare	05/06/2019
Cochlear Implantation	Medical Policy	KY Medicare	05/20/2019
Plethysmography	Medical Policy	KY Medicare	05/20/2019
TMS	Medical Policy	KY Medicare	05/20/2019
Assessing Suitability for Electrical Nerve Stimulation Therapy	Medical Policy	KY Medicare	05/20/2019
Custom Made Oral Appliances for Obstructive Sleep Apnea (OSA)	Medical Policy	KY Medicare	06/17/2019
CPAP for Obstructive Sleep Apnea (OSA)	Medical Policy	KY Medicare	06/17/2019
Polysomnography and Other Sleep Studies	Medical Policy	KY Medicare	06/17/2019
Pulmonary Rehabilitation	Medical Policy	KY Medicare	07/15/2019
CV Nuclear Medicine	Medical Policy	KY Medicare	07/15/2019
Percutaneous Transluminal Angioplasty (PTA)	Medical Policy	KY Medicare	07/15/2019
Ambulatory Blood Pressure Monitors	Medical Policy	KY Medicare	07/15/2019
Cataract Extraction	Medical Policy	KY Medicare	07/15/2019
Bronchial Thermoplasty	Medical Policy	KY Medicare	07/15/2019
Noninvasive Assessment of Liver Fibrosis	Medical Policy	KY Medicare	08/12/2019
Chromosomal Microarray	Medical Policy	KY Medicare	08/12/2019
Glucose Monitoring	Medical Policy	KY Medicare	08/12/2019
Carpal Tunnel	Medical Policy	KY Medicare	09/16/2019
Subcutaneous Implantable Cardioverter Defibrillator	Medical Policy	KY Medicare	09/16/2019
Ambulance (Ground)	Medical Policy	KY Medicare	09/16/2019
Ambulance Services (Air)	Medical Policy	KY Medicare	09/16/2019
Exondys 51	Drug Policy	KY Medicare	09/16/2019
Tysabri	Drug Policy	KY Medicare	09/16/2019
Faslodex	Drug Policy	KY Medicare	09/16/2019
Vimizim	Drug Policy	KY Medicare	09/16/2019
Spinraza	Drug Policy	PA Medicare	10/01/2018
Fetal Aneuploidy	Medical Policy	PA Medicare	10/21/2019
Fetal Aneuploidy	Medical Policy	NC Medicare	10/21/2019
Implantable Automatic Defibrillators	Medical Policy	KY Medicare	10/21/2019
Spinraza	Drug Policy	KY Medicare	11/18/2019
Hyperbaric Oxygen Therapy	Medical Policy	KY Medicare	11/18/2019
Genetic Testing for Warfarin Therapy	Medical Policy	KY Medicare	11/18/2019
Implantable Cardioverter Defibrillator	Medical Policy	KY Medicare	11/18/2019
Upper Gastrointestinal Endoscopy	Medical Policy	KY Medicare	11/18/2019
Subcutaneous Implantable Cardioverter Defibrillator	Medical Policy	PA Medicare	12/09/2019
CV Nuclear Medicine	Medical Policy	PA Medicare	01/20/2020
Noninvasive Liver Assessment	Medical Policy	PA Medicare	03/16/2020
Electrical Stimulators	Medical Policy	PA Medicare	03/16/2020
Faslodex	Drug Policy	PA Medicare	04/13/2020
Herceptin	Drug Policy	PA Medicare	04/13/2020
G-CSF	Drug Policy	PA Medicare	04/13/2020
Adcetris	Drug Policy	PA Medicare	04/13/2020
Kyprolis	Drug Policy	PA Medicare	04/13/2020
Yervoy	Drug Policy	PA Medicare	04/13/2020
Keytruda	Drug Policy	PA Medicare	04/13/2020
Portrazza	Drug Policy	PA Medicare	04/13/2020
Opdivo	Drug Policy	PA Medicare	04/13/2020
Perjeta	Drug Policy	PA Medicare	04/13/2020
Alimta	Drug Policy	PA Medicare	04/13/2020
Plethysmography	Medical Policy	PA Medicare	05/18/2020
ADAKVEO	Medical Policy	PA Medicare	07/01/2020
Exondys 51	Drug Policy	PA Medicare	07/01/2020
Tysabri	Drug Policy	PA Medicare	07/01/2020
Vimizim	Drug Policy	PA Medicare	07/01/2020
Spinraza	Medical Policy	PA Medicare	07/01/2020
Ocrevus	Medical Policy	PA Medicare	07/01/2020
Rituxan	Drug Policy	PA Medicare	07/01/2020
Brineura	Drug Policy	PA Medicare	07/01/2020
Soliris	Medical Policy	PA Medicare	07/01/2020
Interleukin-5 Inhibitors	Drug Policy	PA Medicare	01/01/2021
Xolair	Drug Policy	PA Medicare	01/01/2021
Velcade	Drug Policy	PA Medicare	01/01/2021
Botox (OnabotulinumtoxinA) Injections	Drug Policy	PA Medicare	01/01/2021
Remicade	Drug Policy	PA Medicare	01/01/2021