July 24, 2026
Reimbursement policies, formerly known as clinical payment and coding policies, describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10 coding for claims submitted as covered services. This information is a resource for our payment policies. It’s not intended to address all reimbursement-related issues. We regularly add and modify coding and compensation policy positions as part of our ongoing policy review process.
The following policies were updated:
- RP006 Preventive Services Policy, effective July 1, 2026
- RP010 Anesthesia Information – Professional Provider, effective Oct. 12, 2026
- RP012 Hernia Repair, effective July 10, 2026
- RP022 Pneumatic Compression Devices, effective July 17, 2026
- RP023 Modifier Reference Policy, effective Oct. 19, 2026
- RP039 Outpatient Facility Service(s) Overlapping During an Inpatient Stay, effective June 8, 2026
CPT copyright 2025 American Medical Association. CPT is a registered trademark of the AMA.
Reimbursement policies are based on using healthcare professionals and industry standard guidelines. The coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.