Bundled Services — Non‑Separately Payable Items
This reimbursement policy governs Oscar Health's handling of services considered bundled into other services and specifies items and CPT/HCPCS codes that are not separately payable when billed on the same day by the same provider. It affects providers submitting claims to Oscar Health.
No material clinical or coverage changes in this revision.
Bundling and Non-Separately Payable Rules
Bundled services non-payment rule
Services and items identified as bundled are not separately payable when performed by the same provider in the same session; specific examples and grouping rules follow.
Common clinical/service bundling relationships (examples):
- Cast supplies are bundled into custom foot orthotics.
- CT guidance for insertion of radiation therapy fields is bundled into management of radiation therapy.
- Continuous intraoperative monitoring inside the OR is bundled into continuous intraoperative monitoring outside the OR.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.