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Updated payment policies now available
October 2, 2026

This article is for all providers caring for our members

The following payment policies, updated in Q3 2026, are now available on Provider Central.

Payment policy Updates
CPT and HCPCS Modifiers
  • Updated JZ billing requirements to align with industry standard billing when there are no discarded amounts of a single-dose container drug and/or biological, including NOC and unlisted codes, and no JW modifier amount is reported
Dialysis
  • Annual review; no changes
Drug Wastage
  • Updated JZ billing requirements to align with industry standard billing when there are no discarded amounts of a single-dose container drug and/or biological, including NOC and unlisted codes, and no JW modifier amount is reported
  • Updated billing and coding scenario example 2
Durable Medical Equipment
  • Revised code description for L8035
Early Intervention
  • Corrected code description for H2015
  • Updated title of Autism policy to Applied Behavior Analysis policy
Expanded Molecular Panel Testing of Cancers
  • Added end date to code 0585U
  • Added new code 0696U
General Coding and Billing
  • Updated JZ billing requirements to align with industry standard billing when there are no discarded amounts of a single-dose container drug and/or biological, including NOC and unlisted codes, and no JW modifier amount is reported
  • Updated Category III range to 1111T
Newborn and Neonatal Intensive Care Services
  • Annual review; updated template

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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