medstarfamilychoicedistrictofcolumbia policy updates
Track new and updated medstarfamilychoicedistrictofcolumbia policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Modifier JW (Discarded Drug) and Modifier JZ (No Discard) Reporting | Medstarfamilychoicedistrictofcolumbia | Reimbursement | — | Modified | Jul 28, 2026 |
| Viscosupplementation for Knee Osteoarthritis | Medstarfamilychoicedistrictofcolumbia | Clinical | Orthopedics/Musculoskeletal | Modified | May 1, 2026 |
| Preferred Viscosupplementation Products for Knee Osteoarthritis | Medstarfamilychoicedistrictofcolumbia | Clinical | Orthopedics/Musculoskeletal | Modified | May 1, 2026 |
| Direct Admission for Hospital Observation Services (HCPCS G0379) | Medstarfamilychoicedistrictofcolumbia | Reimbursement | — | Modified | Apr 6, 2026 |
| Cell and Gene Therapy Access Model — Casgevy and Lyfgenia coverage for eligible Medicaid enrollees with sickle cell disease | Medstarfamilychoicedistrictofcolumbia | Clinical | Hematology/Oncology | Modified | Jan 1, 2026 |
| Private Duty Nursing and Skilled Nursing Services - Prepayment Review Edits | Medstarfamilychoicedistrictofcolumbia | Reimbursement | — | Modified | Nov 25, 2025 |
| Biosimilar preferred products list | Medstarfamilychoicedistrictofcolumbia | Clinical | Pharmacy & Specialty Drugs | Modified | Nov 1, 2025 |
| Changes to the DC Health Care Alliance and Immigrant Children's Programs | Medstarfamilychoicedistrictofcolumbia | Administrative | — | Modified | Oct 1, 2025 |
| Private Duty Nursing Care (PDN) — Coverage and Prior Authorization | Medstarfamilychoicedistrictofcolumbia | — | — | Modified | Sep 1, 2025 |
| Provider Alert: Durable Medical Equipment - Tape (Modifiers and NCCI Enforcement) | Medstarfamilychoicedistrictofcolumbia | Reimbursement | — | Modified | Aug 26, 2025 |
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.