Medicaid Policy Search

Name

Type

State

Effective

Ambulance Services – Air

Medical Policy

PA Medicaid

04/01/2025

Ambulance Services – Ground

Medical Policy

PA Medicaid

08/01/2025

Artificial Pancreas

Medical Policy

PA Medicaid

03/01/2026

Automated Ambulatory Blood Pressure Monitoring (ABPM)

Medical Policy

PA Medicaid

10/01/2025

Bariatric Surgery

Medical Policy

PA Medicaid

05/01/2025

BCR-ABL1 Testing in Chronic Myelogenous Leukemia and Acute Lymphoblastic Leukemia

Medical Policy

PA Medicaid

03/01/2025

BRAF Mutation Analysis

Medical Policy

PA Medicaid

10/01/2025

BRCA1 and BRCA2 Genetic Mutation Testing

Medical Policy

PA Medicaid

06/01/2025

Breast Reconstructive Surgery

Medical Policy

PA Medicaid

07/01/2025

Breast Scintimammography

Medical Policy

PA Medicaid

12/01/2025

Bronchial Thermoplasty

Medical Policy

PA Medicaid

10/01/2024

Bronchial Valves

Medical Policy

PA Medicaid

12/01/2025

Capsule Endoscopy

Medical Policy

PA Medicaid

03/01/2025

Cardiac Contractility Modulation (CCM) Therapy

Medical Policy

PA Medicaid

12/01/2025

Cardiac Monitors

Medical Policy

PA Medicaid

04/01/2025

Cardiac Rehabilitation, Phase II Outpatient

Medical Policy

PA Medicaid

08/01/2025

Cardiovascular Disease Laboratory Testing

Medical Policy

PA Medicaid

12/01/2025

Carpal Tunnel Surgery

Medical Policy

PA Medicaid

06/01/2025

Chromosomal Microarray Analysis (CMA): Comparative Genomic Hybridization (CGH) and Single Nucleotide Polymorphism (SNP)

Medical Policy

PA Medicaid

03/01/2024

Clinical Trials

Medical Policy

PA Medicaid

12/01/2025

Cochlear Implants

Medical Policy

PA Medicaid

12/01/2025

Colorectal Cancer Screening

Medical Policy

PA Medicaid

10/01/2024

Concurrent Care

Medical Policy

PA Medicaid

12/01/2025

Cosmetic Procedures

Medical Policy

PA Medicaid

04/01/2025

Deep Brain Stimulation (DBS)

Medical Policy

PA Medicaid

07/01/2025

Drug Testing

Medical Policy

PA Medicaid

09/01/2025

Dual-Energy X-ray Absorptiometry (DXA) for Vertebral Fracture Assessment

Medical Policy

PA Medicaid

12/01/2025

Electrical Bone Growth Stimulators (Noninvasive/Invasive, Spinal, & Ultrasound)

Medical Policy

PA Medicaid

12/01/2025

Electrical Stimulation for Oropharyngeal Dysphagia

Medical Policy

PA Medicaid

12/01/2025

Endoscopic Ultrasound (EUS) and Endoscopic Retrograde Cholangiopancreatography (ERCP)

Medical Policy

PA Medicaid

12/01/2025

Enteral Feeding In-Line Cartridge (EFIC™)

Medical Policy

PA Medicaid

01/01/2025

Exhaled Nitric Oxide Measurement in the Management of Respiratory Disorders

Medical Policy

PA Medicaid

12/01/2025

Experimental/Investigational Laboratory Services

Medical Policy

PA Medicaid

10/01/2025

Experimental/Investigational Services

Medical Policy

PA Medicaid

12/01/2025

Fecal Microbiota Transplant

Medical Policy

PA Medicaid

10/01/2025

Fetal Aneuploidy Testing Using Noninvasive Cell-Free Fetal DNA

Medical Policy

PA Medicaid

04/01/2025

Gastric Electrical Stimulation (GES)

Medical Policy

PA Medicaid

12/01/2025

Gastrointestinal Pathogen Assays

Medical Policy

PA Medicaid

04/01/2025

Gender Affirmation Services

Medical Policy

PA Medicaid

06/01/2025

Gene Expression and Biomarker Prostate Cancer Testing

Medical Policy

PA Medicaid

12/01/2025

Gene Expression Testing for Cancer Treatment (Breast, Colon, Prostate)

Medical Policy

PA Medicaid

03/01/2026

Genetic Testing for Cystic Fibrosis

Medical Policy

PA Medicaid

04/01/2026

Genetic Testing for Lynch Syndrome, Familial Adenomatous Polyposis (FAP), Attenuated FAP and MYH-associated Polyposis

Medical Policy

PA Medicaid

11/01/2024

Genetic Testing for Warfarin and Clopidogrel Therapy

Medical Policy

PA Medicaid

08/01/2025

Home Oxygen Therapy (HOT)

Medical Policy

PA Medicaid

12/01/2025

Hyperbaric Oxygen Therapy (HBOT)

Medical Policy

PA Medicaid

12/01/2025

Hypoglossal Nerve Stimulation Implantation in the Treatment of Obstructive Sleep Apnea

Medical Policy

PA Medicaid

03/01/2025

Hysterectomy for Benign Conditions

Medical Policy

PA Medicaid

10/01/2025

Intraoperative Neurophysiologic Monitoring

Medical Policy

PA Medicaid

04/01/2025

Laboratory Studies for Diagnosing and Managing Inflammatory Bowel Disease

Medical Policy

PA Medicaid

09/01/2025

Liver Fibrosis Assessment Biomarkers

Medical Policy

PA Medicaid

10/01/2025

Long-Term Acute Care (LTAC)

Medical Policy

PA Medicaid

12/01/2025

Lymphoscintigraphy

Medical Policy

PA Medicaid

12/01/2025

Magnetic Resonance-Guided Focused Ultrasound (MRgFUS)

Medical Policy

PA Medicaid

04/01/2025

Minimally Invasive Lumbar Decompression (MILD)

Medical Policy

PA Medicaid

08/01/2025

Molecular Markers for Fine Needle Aspirates of Thyroid Nodules

Medical Policy

PA Medicaid

10/01/2024

Molecular Tumor Markers for Non-Small Cell Lung Cancer (NSCLC)

Medical Policy

PA Medicaid

03/01/2026

Multimarker Serum Testing Related to Ovarian Cancer

Medical Policy

PA Medicaid

03/01/2025

Myoelectric Upper Extremity Orthoses

Medical Policy

PA Medicaid

03/01/2026

Negative Pressure Wound Therapy in the Outpatient Setting

Medical Policy

PA Medicaid

03/01/2025

Nerve Conduction Studies (NCS) and Electromyography (EMG)

Medical Policy

PA Medicaid

04/01/2025

Non-Oncologic Genetic Testing Panels

Medical Policy

PA Medicaid

03/01/2025

Observation and Inpatient Admissions

Medical Policy

PA Medicaid

03/01/2026

Observation Care (Hospital Outpatient)

Medical Policy

PA Medicaid

10/01/2025

Obstetrical Ultrasound

Medical Policy

PA Medicaid

12/01/2024

Oncologic Genetic Testing Panels

Medical Policy

PA Medicaid

11/01/2024

Panniculectomy/Abdominoplasty/Lipectomy

Medical Policy

PA Medicaid

03/01/2025

Passive Oscillatory Devices in the Outpatient Setting

Medical Policy

PA Medicaid

04/01/2025

Pharmacogenetic Testing

Medical Policy

PA Medicaid

12/01/2025

Prescription Digital Therapeutics (e.g., reSET and reSET-O)

Medical Policy

PA Medicaid

02/01/2025

Pulmonary Rehabilitation (PR)

Medical Policy

PA Medicaid

06/01/2025

Pulse Oximetry, Home Use

Medical Policy

PA Medicaid

12/01/2025

Repetitive Transcranial Magnetic Stimulation

Medical Policy

PA Medicaid

12/01/2025

Scanning Computerized Ophthalmic Diagnostic Imaging

Medical Policy

PA Medicaid

03/01/2026

Selected Tests for Rheumatic Diseases

Medical Policy

PA Medicaid

09/01/2025

Serum Biomarker Panel Testing for Systemic Lupus Erythematosus

Medical Policy

PA Medicaid

10/01/2025

Single-use Ambulatory Electrocardiographic Monitors (e.g., Zio Patch)

Medical Policy

PA Medicaid

01/01/2025

Skin Replacement Therapy for Chronic Non healing Wounds in the Outpatient Setting

Medical Policy

PA Medicaid

08/01/2025

Speech Generating Devices

Medical Policy

PA Medicaid

03/01/2026

Supervised Exercise Therapy (SET) in the Management of Peripheral Artery Disease

Medical Policy

PA Medicaid

02/01/2025

Surgical Treatment of Obstructive Sleep Apnea

Medical Policy

PA Medicaid

11/01/2024

Testing for Genetic Disease

Medical Policy

PA Medicaid

04/01/2026

Treatment of the Prostate

Medical Policy

PA Medicaid

08/01/2025

Treatment of Varicose Veins/Venous Insufficiency

Medical Policy

PA Medicaid

03/01/2026

Tumor Markers

Medical Policy

PA Medicaid

02/01/2025

Upper Gastrointestinal Endoscopy (EGD-esophagogastroduodenoscopy)

Medical Policy

PA Medicaid

11/01/2024

Vitamin D Assay Testing

Medical Policy

PA Medicaid

06/01/2024

Vision Therapy (Orthoptics and Pleoptics)

Medical Policy

PA Medicaid

10/01/2025

Wearable Cardioverter-Defibrillators in the Home Setting

Medical Policy

PA Medicaid

09/01/2024

Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders

Medical Policy

PA Medicaid

04/01/2025