• My Account:
  • Sign in
  • Register
QualChoice Health Insurance logo
  • Home
  • Shop Plans & Services
    • Employer Group Plans

      • Level Funding
      • Point of Service (POS)
      • Preferred Provider Organization (PPO)
      • Dental Benefits
      • Vision Benefits
      • Life Insurance

      Employer Group Services

      • Third Party Administration
      • Pharmacy Benefit Management
      • FSA Administration

      Tools & Resources

      • Request a Group Quote
      • Have a Question?
  • Already a Member?
    • Using Your Benefits

      • Getting Started with Your QualChoice Plan
      • Making the Most of Your Benefits
      • Pharmacy and Drug Formularies
      • QualChoice Telehealth
      • Using a Primary Care Physician
      • Dental Benefits Information
      • Using Vision Benefits

      Custom Plans

      • Dillard's Employees
      • Federal Employees

      Health and Wellness

      • QCARE Program
      • A Quality You Member Newsletter
      • Employer News
      • Learn About Flu
      • Learn About Vaccines
      • QuicRewards
      • Stopping Tobacco and Nicotine Use

      Tools & Resources

      • Member Learning Center
      • Using My Account
      • Find a Doctor or Hospital
      • Find a Form or Document
      • Pay My Bill
      • Medical Coverage Policies
      • Services Needing Pre-Authorization
      • Have a Question?
  • For Brokers
    • Using My Account
    • Accessing Secure Email
    • QuicQuote - Broker Quoting Tool
    • Broker News
    • Find A Form or Document
  • For Providers
    • Using My Account
    • Electronic Transactions
    • Find A Form or Document
    • Medical Coverage Policies
    • Policy Updates
    • Archived Policies
    • Pharmacy
    • Utilization Management & Pre-authorization
    • Pre-authorization List
    • Provider Manual
    • Provider News
  • News & Tips
  • About
    • Accessing Secure Email
    • Accreditation and Quality
    • Contact Us
    • Healthcare Fraud
    • Medical Loss Ratio — FAQ

Policy Updates

  • Home
  • For Providers
  • Policy Updates

Clinical Coverage/Medical Policy Updates

QualChoice updates a select number of clinical coverage policies each month, ensuring the reviewal of all policies on an annual basis.

Policy Updates Effective November 15, 2026
CP.BH.300 - Biofeedback for Behavioral Disorders (PDF)
CP.MP.150 - Phototherapy for Neonatal Hyperbilirubinemia (PDF)
CP.MP.86 - Neonatal Abstinence Syndrome Guidelines (PDF)
AR.CP.MP.502 - Outpatient Acquired Brain Injury Services (PDF)
CP.MP.186 - Burn Surgery (PDF)
CP.MP.247 - Transplant Service Documentation Requirements (PDF)
CP.MP.253 - Unproven Procedures (PDF)
CC.PP.206 - Skilled Nursing Facility Leveling (PDF)
Policy Updates Effective December 1, 2026
ASAM 4th Edition for Youth/Adolescents
Policy Updates Effective December 15, 2026
CP.MP.133 - Posterior Tibial Nerve Stimulation for Voiding Dysfunction (PDF)
CP.MP.165 - Selective Nerve Root Blocks and (PDF)
CP.MP.166 - Sacroiliac Joint Interventions for Pain Management (PDF)
Policy Updates Effective January 15, 2027
CP.MP.54 - Hospice Services (PDF)
CP.MP.107 - Durable Medical Equipment and Orthotics and Prosthetics Guidelines (PDF)
CP.MP.249 - Allogeneic Hematopoietic Progenitor Cell Therapy (PDF)
AR.CP.MP.031 - Cosmetic and Reconstructive Procedures (PDF)
Policy Updates Effective February 15, 2027
CP.MP.108 - Allogeneic Hematopoietic Cell Transplants for Sickle Cell Anemia and Beta-thalassemia (PDF)
CP.MP.185 - Skin and Soft Tissue Substitutes (PDF)
QualChoice Health Insurance logo

QualChoice is committed to giving great customer service!

Legal Notices

  • Privacy
  • Terms of Use
  • Medicare Part D Notice
  • Member Rights
  • Your Right to Appeal
  • Transparency in Coverage Machine Readable Files
  • Non-discrimination & Language Help

About QualChoice

  • About Us
  • Contact Us
  • Facebook (opens in a new tab)
  • YouTube (opens in a new tab)
  • LinkedIn (opens in a new tab)

Copyright © 2026 QualChoice.  All rights reserved. | Site Map