纽约州提供者政策图书馆

请注意,当前的政策列表并非详尽无遗,而是提供者表示有兴趣查看的政策集合。 对这些已发布政策和/或其他政策的修订、修改、补充可能会在不久的将来发布。 如果您对这些政策有任何疑问,请联系您的提供商关系代表。 此外,这些文件专门针对纽约州的 Centene Corporation 和 Fidelis Care 健康计划。


Eye_on_Vision_Health



纽约临床政策


临床文件 (A-Z)
Clinical Policy: Allogeneic SCT (Adults)
  • Reference Number: CP.FC.31
  • PDF Publish Date: 4/1/2021

Clinical Policy: Allogeneic SCT (Pediatric)
  • Reference Number: CP.FC.32
  • PDF Publish Date: 4/1/2022

Clinical Policy: Autologous SCT (Adults)
  • Reference Number: CP.FC.30
  • PDF Publish Date: 4/1/2021

Clinical Policy: Autologous SCT (Pediatric)
  • Reference Number: CP.FC.33
  • PDF Publish Date: 4/1/2022

Reference Number: CP.MP.93
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.FC.42
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.CPC.01
  • PDF Publish Date: 3/1/2021

  • Reference Number: CP.FC.43
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.MP.94
  • PDF Publish Date: 7/1/2021

  • Reference Number: CP.MP.14
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.MP.31
  • PDF Publish Date: 11/1/2021

  • Reference Number: CP.FC.02
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.MP.203
  • PDF Publish Date: 1/1/2021

  • Reference Number: CP.MP.115
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.MP.101
  • PDF Publish Date: 11/1/2021

  • Reference Number: CP.FC.06
  • PDF Publish Date: 10/1/2021

  • Reference Number: CP.FC.18
  • PDF Publish Date: 11/1/2021

  • Reference Number: CP.MP.137
  • PDF Publish Date: 8/1/2021

  • Reference Number: CP.MP.129
  • PDF Publish Date: 8/1/2021

  • Reference Number: CP.MP.40
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.MP.89
  • PDF Publish Date: 1/1/2022

  • Reference Number: CP.MP.132
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.FC.21
  • PDF Publish Date: 3/1/2021

  • Reference Number: CP.MP.180
  • PDF Publish Date: 12/1/2021

  • Reference Number: CP.MP.160
  • PDF Publish Date: 5/1/2022

  • Reference Number: CP.FC.26
  • PDF Publish Date: 1/1/2022

  • Reference Number: CP.MP.167
  • PDF Publish Date: 9/1/2021

  • Reference Number: CP.MP.58
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.MP.123
  • PDF Publish Date: 4/1/2022

  • Reference Number: CP.MP.244
  • PDF Publish Date: 8/1/2022

  • Reference Number: CP.MP.57
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.MP.116
  • PDF Publish Date: 8/1/2022

  • Clinical Policy: Mechanical Stretching Devices
    • Reference Number: CP.MP.144
    • PDF Publish Date: 5/1/2021

    Clinical Policy: Medical Necessity Criteria
    • Reference Number: CP.FC.05
    • PDF Publish Date: 7/1/2022

    Reference Number: CP.MP.24
  • PDF Publish Date: 5/1/2021

  • Reference Number: CP.MP.170
  • PDF Publish Date: 10/1/2021

  • Reference Number: CP.MP.141
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.MP.202
  • PDF Publish Date: 11/1/2021

  • Reference Number: CP.FC.20
  • PDF Publish Date: 7/1/2022

  • Clinical Policy: Outpatient Testing for DOA
    • Reference Number: CP.FC.17
    • PDF Publish Date: 1/1/2021

    Clinical Policy: Pancreas Transplantation
    • Reference Number: CP.MP.102
    • PDF Publish Date: 3/1/2022

    Reference Number: CP.MP.109
  • PDF Publish Date: 12/1/2021

  • Reference Number: CP.FC.36
  • PDF Publish Date: 4/1/2021

  • Reference Number: CP.MP.138
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.MP.120
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.MP.188
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.FC.44
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.MP.147
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.MP.151
  • PDF Publish Date: 12/1/2021

  • Reference Number: CP.FC.22
  • PDF Publish Date: 7/1/2021

  • Reference Number: CP.MP.133
  • PDF Publish Date: 1/1/2022

  • Reference Number: CP.MP.187
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.MP.51
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.FC.24
  • PDF Publish Date: 7/1/2021

  • Reference Number: CP.MP.166
  • PDF Publish Date: 9/1/2021

  • Reference Number: CP.MP.146
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.MP.174
  • PDF Publish Date: 12/1/2021

  • Reference Number: CP.FC.41
  • PDF Publish Date: 4/1/2021

  • Reference Number: CP.FC.28
  • PDF Publish Date: 1/1/2022

  • Reference Number: CP.MP.108
  • PDF Publish Date: 12/1/2021

  • Reference Number: CP.FC.34
  • PDF Publish Date: 1/1/2022

  • Reference Number: CP.FC.40
  • PDF Publish Date: 6/1/2021

  • Reference Number: CP.MP.162
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.FC.27
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.FC.35
  • PDF Publish Date: 7/1/2022

  • Reference Number: CP.MP.127
  • PDF Publish Date: 12/1/2021

  • Reference Number: CP.FC.03
  • PDF Publish Date: 6/1/2021

  • Clinical Policy: Transforaminal Epidural Injections
    • Reference Number: CP.MP.165
    • PDF Publish Date: 9/1/2021

    Reference Number: CP.MP.169
  • PDF Publish Date: 9/1/2021

  • Reference Number: CP.MP.142
  • PDF Publish Date: 12/1/2021

  • Reference Number: CP.FC.39
  • PDF Publish Date: 6/1/2021

  • Reference Number: CP.MP.46
  • PDF Publish Date: 3/1/2022

  • Reference Number: CP.MP.177
  • PDF Publish Date: 2/1/2022

  • Reference Number: CP.MP.143
  • PDF Publish Date: 11/1/2021


  • 纽约付款文件


    付款文件 (A-Z)
    Payment Policy: 14 Day Readmission (Medicaid)
    • Reference Number: FC.PP.003
    • PDF Publish Date: 8/1/2021

    Payment Policy: 25-hydroxyvitamin D Testing in Children and Adolescents
    • Reference Number: FC.PP.027
    • PDF Publish Date: 2/1/2022

    Payment Policy: 30 Day Readmission (Medicare)
    • Reference Number: FC.PP.004
    • PDF Publish Date: 10/15/2021

    Payment Policy: 340B Drug Payment Reduction
    • Reference Number: CC.PP.070
    • PDF Publish Date: 1/1/2022

    Payment Policy: Allergy Testing and Therapy
    • Reference Number: FC.PP.026
    • PDF Publish Date: 7/1/2022

    Payment Policy: Ambulatory Electroencephalography
    • Reference Number: FC.PP.015
    • PDF Publish Date: 9/1/2021

    Payment Policy: Bronchial Thermoplasty
    • Reference Number: FC.PP.017
    • PDF Publish Date: 1/1/2022

    Payment Policy: Claim Validation of Modifier 25
    • Reference Number: FC.PP.001
    • PDF Publish Date: 8/1/2021

    Payment Policy: Claim Validation of Modifier 59
    • Reference Number: FC.PP.002
    • PDF Publish Date: 8/1/2021

    Payment Policy: CMS Correct Coding Initiative
    • Reference Number: FC.PP.020
    • PDF Publish Date: 10/15/2021

    Payment Policy: Digital EEG Spike Analysis
    • Reference Number: FC.PP.011
    • PDF Publish Date: 11/1/2021

    Payment Policy: EEG in the Evaluation of Headache
    • Reference Number: FC.PP.014
    • PDF Publish Date: 11/1/2021

    Payment Policy: Emergency Department Evaluation and Management Claim Adjustment
    • Reference Number: FC.PP.005
    • PDF Publish Date: 6/1/2022

    Payment Policy: Endometrial Ablation
    • Reference Number: FC.PP.010
    • PDF Publish Date: 6/1/2022

    Payment Policy: Evaluation and Management Claim Adjustment
    • Reference Number: FC.PP.006
    • PDF Publish Date: 6/1/2022

    Payment Policy: Evoked Potential Testing
    • Reference Number: FC.PP.019
    • PDF Publish Date: 11/1/2021

    Payment Policy: Helicobacter Pylori Serology Testing
    • Reference Number: FC.PP.018
    • PDF Publish Date: 11/1/2021

    Payment Policy: Low-Frequency Ultrasound and Noncontact Normothermic Wound Therapy
    • Reference Number: FC.PP.028
    • PDF Publish Date: 5/1/2022

    Payment Policy: Maximum Units of Service
    • Reference Number: CC.PP.007
    • PDF Publish Date: 1/1/2022

    Payment Policy: Measure of Serum 1.25 (Vitamin D)
    • Reference Number: FC.PP.012
    • PDF Publish Date: 11/1/2021

    Payment Policy: National Diabetes Prevention Program (NDPP)
    • Reference Number: FC.PP.021
    • PDF Publish Date: 1/1/2022

    Payment Policy: Physician's Office Lab Testing
    • Reference Number: CC.PP.055
    • PDF Publish Date: 9/1/2021

    Payment Policy: Pre-Payment and Post-Payment Review (Non-Medicare)
    • Reference Number: FC.PP.007
    • PDF Publish Date: 11/1/2021

    Payment Policy: Pre-Payment and Post-Payment Review (Medicare)
    • Reference Number: FC.PP.008
    • PDF Publish Date: 1/1/2022

    Payment Policy: Renal Hemodialysis
    • Reference Number: CC.PP.067
    • PDF Publish Date: 3/1/2022

    Payment Policy: Spinal Muscular Atrophy (SMA) Carrier Screening in Pregnancy
    • Reference Number: FC.PP.033
    • PDF Publish Date: 6/1/2022

    Payment Policy: Status "B" Bundled Services
    • Reference Number: CC.PP.046
    • PDF Publish Date: 1/1/2022

    Payment Policy: Status "P" Bundled Services
    • Reference Number: CC.PP.049
    • PDF Publish Date: 1/1/2022

    Payment Policy: Testing for Select Genitourinary Conditions
    • Reference Number: FC.PP.022
    • PDF Publish Date: 1/1/2022

    Payment Policy: Thyroid Insulin Tests in Pediatrics
    • Reference Number: FC.PP.013
    • PDF Publish Date: 11/1/2021

    Payment Policy: Transabdominal and Transvaginal Ultrasounds
    • Reference Number: FC.PP.009
    • PDF Publish Date: 3/1/2022

     


     

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