Payment policies

• Ambulance and transportation service payment policy (pdf, 132 KB)
• Ambulatory surgery — facility payment policy (pdf, 81 KB)
• Ambulatory surgery — professional payment policy (pdf, 80 KB)
• Anesthesia payment policy (pdf, 80 KB)
• Assistant surgeon payment policy (pdf, 71 KB)
• Cardiology services payment policy (pdf, 77 KB)
• Claims auditing software policy
  • Current policy (pdf, 60 KB)
  • Revised policy, effective 5/1/2010 (59 KB)
• Clinical trials payment policy (pdf, 105 KB)
• Coding analysis policy
  • Current policy (pdf, 55 KB)
  • Revised policy, effective 5/1/2010 (pdf, 54 KB)
• Counseling/risk factor reduction intervention services payment policy (pdf, 51 KB)
• CRNA payment policy (pdf, 62 KB)
• Dermatology payment policy (pdf, 78 KB)
• Durable medical equipment capped rental payment policy (pdf, 76 KB)
• Emergency department payment policy
  • Current policy (pdf, 71 KB)
  • Revised policy, effective 5/1/2010 (pdf, 80 KB)
• Evaluation and management payment policy (pdf, 119 KB) 
• Eye examinations and refraction payment policy (pdf, 68 KB)
• Facility bill/charge audit policy
  • Current policy (pdf, 74 KB)
  • Revised policy, effective 5/1/2010 (pdf, 84 KB) - name change to Provider Audit Payment Policy
• Gastroenterology payment policy (pdf, 82 KB)
• Global obstetrical services policy (pdf, 82 KB)
• Global surgical payment policy (pdf, 82 KB)
• Hearing aid and hearing aid exam payment policy (pdf, 61 KB)
• Hospice payment policy (pdf, 129 KB)
• Hospice and palliative medicine consult payment policy (pdf, 67 KB)
• Hospital acquired conditions payment policy (pdf, 88 KB)
• Human leukocyte antigen testing payment policy (pdf, 77 KB)
• Infertility/assisted reproductive technology services payment policy (pdf, 209 KB)
• Inpatient medical review and payment policy (pdf, 72 KB)
• Laboratory and pathology payment policy 
• Maximum units payment policy (pdf, 74 KB)
• Medical nutrition therapy payment policy (pdf, 50 KB)
• Medical supplies and surgical dressing payment policy (pdf, 393 KB)
• Member liability policy
  • Current policy (pdf, 54 KB)
  • Revised policy, effective 5/1/2010 (pdf, 64 KB)
• Neonatal intensive care services payment policy (pdf, 66KB)
• Non-covered services payment policy
  • Current policy  (pdf, 176 KB)
  • Revised policy, effective 5/1/2010 (pdf, 166 KB) 
• Nurse midwife policy (78 KB)
• Nurse practitioner payment policy (pdf, 78 KB)
• Observation status payment policy (pdf, 80 KB)
• Outpatient drugs payment policy effective 11/1/09 (pdf, 64 KB)
• Physician assistant payment policy (pdf, 88 KB)
• Physician standby services policy (pdf, 50 KB)
• Physical therapy assistant payment policy (pdf, 58 KB)
• Preoperative autologous blood donation payment policy (pdf, 89 KB) 
• Procedure code review policy (pdf, 59 KB)
• Radiology/diagnostic imaging payment policy (pdf, 95 KB)
• Registered nurse first assistant payment policy (pdf, 48 KB)
• Serious reportable events payment policy (pdf, 87 KB)
• Special services, procedures and reports payment policy
  • Current policy (pdf, 66 KB)
  • Revised policy, effective 5/1/2010 (pdf, 74 KB)
• Team conferences and telephone consults service payment policy (pdf, 56 KB)
• Timely filing payment policy (pdf, 58 KB)
• Transplant payment policy (pdf, 94 KB)
• Unlisted procedures and services payment policy (pdf, 68 KB)
• Vaccine payment policy (pdf, 175 KB)
• Well baby/well child care visits payment policy (pdf, 76 KB)