care_continuum policy updates
Track new and updated care_continuum policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Sequestration Policy | Care Continuum | Reimbursement | — | Modified | Jun 2, 2027 |
| Lesser of Provider Reimbursement Policy | Care Continuum | Reimbursement | — | Modified | Mar 23, 2027 |
| Orthognathic Surgery | Care Continuum | Clinical | Dental/Oral & Maxillofacial | Modified | Jun 18, 2026 |
| Complementary and Alternative Medicine | Care Continuum | Clinical | Pain Management | Modified | Jun 18, 2026 |
| Nerve blocks and ablation therapy for the treatment of (Peripheral nerve blocks and nerve ablation) | Care Continuum | Clinical | Pain Management | Modified | Jun 18, 2026 |
| Breast implant removal and/or replacement | Care Continuum | Clinical | Plastic/Reconstructive Surgery | Modified | Jun 18, 2026 |
| Endobronchial valves for treatment of severe emphysema | Care Continuum | Clinical | Pulmonology | Modified | Jun 18, 2026 |
| Medication coverage change log — specialty drug prior authorization and duration updates | Care Continuum | Clinical | Pharmacy & Specialty Drugs | Modified | May 1, 2026 |
| Home phototherapy units for the treatment of skin conditions | Care Continuum | Clinical | Dermatology | Modified | Apr 16, 2026 |
| Specialized Manual Wheelchair Bases | Care Continuum | Clinical | Durable Medical Equipment (DME) | Modified | Apr 16, 2026 |
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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.
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.