Moda Health policy updates
Track new and updated Moda Health policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Add-on Codes | Moda Health | Reimbursement | — | Modified | Jul 8, 2026 |
| Breast Implant Removal | Moda Health | Clinical | Plastic/Reconstructive Surgery | Modified | Jul 1, 2026 |
| Corneal Collagen Cross-linking for Treatment of Keratoconus | Moda Health | Clinical | Ophthalmology/Optometry | Modified | Jul 1, 2026 |
| Qualifying Circumstances for Anesthesia | Moda Health | Reimbursement | — | Modified | Jun 10, 2026 |
| Operating Microscope (CPT Code 69990) | Moda Health | Reimbursement | — | Modified | Jun 10, 2026 |
| Continuous Glucose Monitoring (CGM) | Moda Health | Clinical | Endocrinology | Modified | Jun 1, 2026 |
| Valid Modifier to Procedure Code Combinations | Moda Health | Reimbursement | — | Modified | May 13, 2026 |
| Modifiers 58, 78, and 79 - Staged, Related, and Unrelated Procedures | Moda Health | Reimbursement | — | Modified | May 13, 2026 |
| Records Fees, Copying Fees | Moda Health | Reimbursement | — | Modified | May 13, 2026 |
| Cosentyx (secukinumab) (Subcutaneous/Intravenous) — Prior Authorization and Medical Necessity | Moda Health | Clinical | Immunology/Rheumatology | Modified | May 5, 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.