Blue Cross Blue Shield - Wyoming Coverage Criteria
Latest Blue Cross Blue Shield - Wyoming coverage criteria updates9
- Coverage CriteriaClinical/Medical PolicyEff. 2026-01-01Preventive Care Benefits — Coverage CriteriaDefines preventive care services covered (deductible and coinsurance waived) under certain Blue Cross Blue Shield - Wyoming lines of business when provided in-network or at approved health fairs; applies to participants/members as described by service categories and age ranges.All Blue Cross Blue Shield - Wyoming updates
- Coverage CriteriaClinical/Medical PolicyEff. 2025-07-01Preventive Care Benefits (Coverage Criteria)All Blue Cross Blue Shield - Wyoming updates
- Coverage CriteriaClinical/Medical PolicyEff. 2025-07-01Preventive Care Benefits — Coverage CriteriaDefines covered preventive and wellness services (screenings, immunizations, counseling, and selected preventive medications and supplies) for eligible members when the member's Preventive Care definition includes USPSTF (A/B), ACIP, HRSA, and Bright Futures; services must be delivered by participating/in-network or health fair providers to be covered.All Blue Cross Blue Shield - Wyoming updates
- Coverage CriteriaClinical/Medical PolicyEff. 2025-01-01Preventive Care Benefits (Preventive Services & Screening Coverage Criteria)Defines preventive and wellness services covered (deductible and coinsurance waived) for applicable lines of business, including covered screenings, immunizations, counseling, contraceptives, and select prescription preventive medications for Blue Cross Blue Shield - Wyoming members.All Blue Cross Blue Shield - Wyoming updates
- Coverage CriteriaClinical/Medical PolicyEnteral Nutrition (Mandated and Expanded Benefit)Defines coverage, patient selection, and benefit administration for enteral nutrition (oral or tube-delivered enteral formulas and amino acid–based elemental formulas) for Blue Cross Blue Shield - Wyoming members, including state-mandated and expanded benefit conditions.All Blue Cross Blue Shield - Wyoming updates
- Coverage CriteriaClinical/Medical PolicyPreventive Care Benefits (Coverage Criteria)Defines preventive and wellness services covered (deductible and coinsurance waived) for eligible members and specifies provider/network requirements for Blue Cross Blue Shield - Wyoming products. Applicable services follow USPSTF (A/B), ACIP, HRSA, and Bright Futures recommendations where indicated.All Blue Cross Blue Shield - Wyoming updates
- Coverage CriteriaClinical/Medical PolicyPreventive Care Benefits — Coverage CriteriaDefines preventive and wellness services covered (deductible and coinsurance waived) for applicable Blue Cross Blue Shield - Wyoming plans; applies to services delivered by participating/network providers or health fairs and when plan's preventive definition includes USPSTF A/B, ACIP, HRSA, and Bright Futures recommendations.All Blue Cross Blue Shield - Wyoming updates
- Coverage CriteriaClinical/Medical PolicyPreventive Care Benefits — Coverage CriteriaDefines covered preventive and wellness services, screenings, immunizations, and related prescription preventive drugs for eligible members and specifies that services must be delivered by participating providers; applicability varies by line of business and member benefit documents.All Blue Cross Blue Shield - Wyoming updates
- Coverage CriteriaClinical/Medical PolicyPreventive Care Benefits — Coverage CriteriaDefines preventive and wellness services covered (deductible and coinsurance waived) for applicable Blue Cross Blue Shield - Wyoming plans and lines of business, and who may be eligible based on the member's benefit document and network participation.All Blue Cross Blue Shield - Wyoming updates
1–9 of 9
1 / 1
Tool Description
Search Blue Cross Blue Shield - Wyoming coverage criteria and medical necessity requirements across 21,000+ policies from 170+ payers.
Search a drug (“Wegovy”), a procedure (“knee replacement”), or a policy name, then filter by payer, specialty, policy type, or effective year. Or start from the largest publishers: UnitedHealthcare coverage criteria and Cigna coverage criteria.
Each result links the full policy page, which lists the clinical requirements, covered codes, and effective dates from the source document.
Pair a criteria search with the prior authorization lookup for approval requirements, the timely filing lookup for claim deadlines, the live policy updates feed for the newest payer publications, and payer profiles for contacts and coverage context.
FAQ
Coverage criteria are the specific clinical requirements a payer sets for covering a drug, procedure, or service: diagnoses, symptom duration, prior treatments tried, age limits, and documentation. They are published inside medical policies and clinical criteria documents, and a claim or authorization that does not meet them is denied as not medically necessary.
Coverage Criteria by Payer
Go deeper
Explore OpenPayer Data
Coverage policies are updated every day. Follow payer coverage policy updates in the live policy feed, or browse all CPT, HCPCS and DRG billing codes.
Toolbox
More OpenPayer Tools
- Billing Code LookupSearch CPT, HCPCS, J-codes, DRG, and dental codes by number or procedure name.
- Billing Code Reimbursement RatesBuild a reimbursement rate report across any mix of billing codes and states, comparing commercial payers against Medicare.
- Payer Comparison DashboardPick 2-5 payers to compare market share, premium, and membership by region, all at once.
- Facility Comparison DashboardPick 2-6 hospital facility types (or add a specific hospital) to compare facility count, revenue, net income, and Medicare/Medicaid payer mix by region, all at once.
- Healthcare Provider & Facility LookupFind hospitals and healthcare facilities by name, taxonomy, facility type, ownership, or state.
- Health Insurance Payer LookupSearch national health insurance payers and health plans by name and state presence.
- Provider Taxonomy Code LookupSearch NUCC taxonomy codes by code, specialty, grouping, or classification.
- CPT Modifier LookupSearch CPT modifiers by code or name — descriptions, when to use them, and payer policy context.
- Prior Authorization LookupSearch payer prior authorization policies by drug, procedure, or policy name.
- Timely Filing LookupFind payer timely filing policies: claim deadlines, corrected claim windows, and appeal timeframes.
- Payer Contact DirectoryClaims, prior authorization, provider services, and appeals contacts for health insurance payers.
Published by
Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.