Reimbursement/Payment Policy policy updates
Track new and updated Reimbursement/Payment Policy policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Payment Policy: Skilled Nursing Facility Leveling | Ambetter Nevada | Reimbursement | — | Modified | Aug 1, 2026 |
| Intraoperative Neurophysiology Monitoring (IONM) - Reimbursement Policy | Ambetter Nevada | Reimbursement | — | Modified | Jun 1, 2026 |
| Payment Policy: Code Editing Overview | Ambetter Nevada | Reimbursement | — | Modified | Feb 12, 2025 |
| Payment Policy: Reporting the Global Maternity Package | Ambetter Nevada | Reimbursement | — | Modified | Jan 1, 2025 |
| Intravenous Hydration Payment Policy (CPT 96360/96361) | Ambetter Nevada | Reimbursement | — | Modified | Jan 1, 2025 |
| Payment Policy: Maximum Units of Service | Ambetter Nevada | Reimbursement | — | Modified | Jan 1, 2025 |
| Unlisted Procedure Codes payment policy | Ambetter Nevada | Reimbursement | — | Modified | Jan 1, 2025 |
| Distinct Procedural Modifiers: XE, XS, XP, & XU | Ambetter Nevada | Reimbursement | — | Modified | Jan 1, 2025 |
| Payment Policy: Post-operative Visits | Ambetter Nevada | Reimbursement | — | Modified | Dec 1, 2024 |
| Pre-operative Visits / E/M Services Within Global Surgical Periods | Ambetter Nevada | Reimbursement | — | Modified | Dec 1, 2024 |
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.