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Updated payment policies now available
October 3, 2025

This article is for all providers caring for our members

The following payment policies, updated in Q3 2025, are now available on Provider Central.

Payment policy Updates
Drug Testing
  • Annual review; updated template
Durable Medical Equipment
  • Added new breast pump supply code A4288
  • Updated information in 1500 Health Insurance Claim Form and 837 Professional Electronic Submission table for service facility location and billing a NOC code
Early Intervention
  • Annual review; updated template
Electronic Funds Transfer (EFT)
  • Annual review; updated template
Emergency Room- Facility
  • Annual review; updated template
  • Edited to clarify general reimbursement regarding industry standard emergency department E/M facility coding
Expanded Molecular Panel Testing of Cancers
  • Updated template
  • Added new code 0585U effective October 1, 2025
Immunizations
  • Updated template
  • Revised reimbursement status for 90589 due to FDA update
Radiology
  • Edited to clarify outpatient radiology services

Download our payment policies.

To download our payment policies, log in and click Find a Payment Policy on the right side of your home page. Or, go to Office Resources>Policies & Guidelines>Payment Policies.

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