Amerigroup policy updates
Track new and updated Amerigroup policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Genetic Testing: Once per Lifetime | Amerigroup | Clinical | Genetic & Molecular Testing | Modified | Jul 1, 2026 |
| Site-of-care requirements for specialty drugs (site-of-care drug list) | Amerigroup | Clinical | Pharmacy & Specialty Drugs | Modified | Apr 1, 2026 |
| Reimbursement Policy — Modifier 76 | Amerigroup | Reimbursement | Other | Modified | Jan 26, 2026 |
| Reimbursement Policy Modifier 77 | Amerigroup | Reimbursement | Other | Modified | Jan 26, 2026 |
| Modifier 50 and 51: Multiple and Bilateral Surgery | Amerigroup | Reimbursement | Other | Modified | Dec 18, 2025 |
| Consultations | Amerigroup | Reimbursement | — | Modified | Dec 2, 2025 |
| Reimbursement Policy Maximum Units Per Day | Amerigroup | Reimbursement | Preventive Services & Screening | Modified | Dec 2, 2025 |
| Reimbursement Policy Professional Anesthesia Services | Amerigroup | Reimbursement | — | Modified | Nov 14, 2025 |
| Reimbursement Policy Drug Screen Testing | Amerigroup | Reimbursement | Laboratory/Pathology | Modified | Nov 14, 2025 |
| Reimbursement Policy Maternity Services | Amerigroup | Reimbursement | — | Modified | Oct 23, 2025 |
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OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
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Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.