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 December 1, 2025

CP.MP.165 - SNRB and TFESI (PDF)
CP.MP.166 - Sacroiliac Joint Interventions for Pain Management (PDF)

Policy Updates Effective December 15, 2025

CP.MP.22 - Stereotactic Body Radiation Therapy (PDF)
CP.MP.144 - Mechanical Stretching Devices for Joint Stiffness and Contracture (PDF)
CP.MP.145 - Electric Tumor Treating Fields (Optune) (PDF)

Policy Updates Effective January 1, 2026

CP.MP.202 - Orthognathic Surgery (PDF)
AR.CP.MP.37 Bariatric Surgery (PDF)
AR.CP.MP.31 Cosmetic and Reconstructive Procedures (PDF)
AR.CP.MP.501 Acquired Brain Injury Outpatient Services (PDF)

Policy Updates Effective February 1, 2026

CP.MP.61 - IV Moderate Sedation, IV Deep Sedation, and General Anesthesia for Dental Procedures (PDF)
CP.BH.104 - Applied Behavior Analysis (PDF)

Policy Updates Effective March 15, 2025

CP.MP.185 - Skin and Soft Tissue Substitutes for Chronic Wounds (PDF)
CP.MP.188 - Pediatric Oral Function Therapy (PDF)
CP.MP.247 - Transplant Service Documentation Requirements (PDF)
CP.MP.248 - Facility-based Sleep Studies for Obstructive Sleep Apnea (PDF)