Reimbursement/Payment Policy policy updates
Track new and updated Reimbursement/Payment Policy policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Durable Medical Equipment and Supplies | Capital Bluecross | Reimbursement | Durable Medical Equipment (DME) | Modified | Jul 1, 2026 |
| Peripheral Subcutaneous Field Stimulation (PSFS) | Capital Bluecross | Reimbursement | Pain Management | Modified | Sep 1, 2025 |
| Value Opioid drug list update | Capital Bluecross | Reimbursement | — | Modified | Jan 1, 2025 |
| Value Plus - Opioid drug list update | Capital Bluecross | Reimbursement | — | Modified | Jan 1, 2025 |
| Serum Testing for Evidence of Mild Traumatic Brain Injury | Capital Bluecross | Reimbursement | Laboratory/Pathology | Modified | Apr 19, 2021 |
| Blenrep® (belantamab mafodotin-blmf) | Capital Bluecross | Reimbursement | Pharmacy & Specialty Drugs | Modified | Sep 1, 2020 |
| Flow Cytometry | Capital Bluecross | Reimbursement | Laboratory/Pathology | Modified | Nov 16, 2015 |
| Coronavirus Testing in the Outpatient Setting | Capital Bluecross | Reimbursement | Infectious Disease | Modified | Sep 18, 2015 |
| Coronavirus Testing in the Outpatient Setting | Capital Bluecross | Reimbursement | Infectious Disease | Modified | Sep 18, 2015 |
| Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing | Capital Bluecross | Reimbursement | Laboratory/Pathology | Modified | Sep 18, 2015 |
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.
OpenPayer by Trek Health — Policy intelligence for billing and revenue cycle teams.
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.