Molina Healthcare policy updates
Track new and updated Molina Healthcare policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Notice of Privacy Practices (use and disclosure of PHI) | Molina Healthcare | Administrative | Other | Modified | Jan 1, 2026 |
| Serum Testing for Evidence of Mild Traumatic Brain Injury | Molina Healthcare | Reimbursement | Neurology/Neurosurgery | Modified | Oct 15, 2025 |
| Cardiovascular Disease Risk Assessment | Molina Healthcare | Reimbursement | Cardiology | Modified | Oct 15, 2025 |
| Biomarker Testing for Autoimmune Rheumatic Disease | Molina Healthcare | Reimbursement | Immunology/Rheumatology | Modified | Jul 1, 2025 |
| Helicobacter pylori Testing | Molina Healthcare | Reimbursement | Gastroenterology | Modified | Jul 1, 2025 |
| Human Immunodeficiency Virus (HIV) | Molina Healthcare | Reimbursement | Infectious Disease | Modified | Jul 1, 2025 |
| Lyme Disease Testing | Molina Healthcare | Reimbursement | Infectious Disease | Modified | Jul 1, 2025 |
| Condition Codes 49, 50 and 53 | Molina Healthcare | Reimbursement | Other | Modified | Apr 28, 2025 |
| Diabetes Mellitus Testing (A1c, FPG, OGTT) - Coverage and Payment | Molina Healthcare | Reimbursement | Endocrinology | Modified | Apr 1, 2025 |
| Use of modifier 59 and X(EPSU) modifiers for billing | Molina Healthcare | Reimbursement | Other | Modified | Oct 23, 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.