Longevityhealthplanofcolorado Coverage Criteria
Latest Longevityhealthplanofcolorado coverage criteria updates10
- Coverage CriteriaClinical/Medical PolicyEff. 2025-12-12Supplemental BenefitsDefines Longevity Health Plan of Colorado's coverage criteria and prior authorization requirements for supplemental benefits (e.g., dental, hearing aids) offered to plan beneficiaries; applies to providers and members under the Plan.All longevityhealthplanofcolorado updates
- Coverage CriteriaClinical/Medical PolicyEff. 2025-02-26Pharmacogenetic TestingCoverage criteria and prior authorization requirements for pharmacogenetic testing for Longevity Health Plan of Colorado members, including which gene–drug pairs (CPIC levels A/B) are considered appropriate. Affects providers ordering pharmacogenetic tests and labs performing them.All longevityhealthplanofcolorado updates
- Coverage CriteriaClinical/Medical PolicyEff. 2024-01-04Mental Health Services Policy (Mental Health Services Coverage, Prior Authorization, and Medical Necessity Criteria)This policy governs Longevity Health Plan of Colorado's coverage, prior authorization, and medical necessity criteria for mental health services (including psychotherapy, psychological testing, and related psychiatric procedures) for plan enrollees.All longevityhealthplanofcolorado updates
- Coverage CriteriaClinical/Medical PolicyEff. 2022-08-30Wound CareDefines coverage criteria and documentation requirements for wound care services (debridement, negative pressure wound therapy, low-frequency non-contact non-thermal ultrasound/MIST) and states that fluorescent imaging is experimental; applies to Longevity Health Plan of Colorado members.All longevityhealthplanofcolorado updates
- Coverage CriteriaClinical/Medical PolicyDiabetic ShoesDefines prior authorization, documentation, and medical necessity criteria Longevity Health Plan uses to cover therapeutic shoes and inserts for members with diabetes; applies to providers submitting requests for beneficiaries in the Plan.All longevityhealthplanofcolorado updates
- Coverage CriteriaClinical/Medical PolicyDurable Medical Equipment (DME)Defines coverage, prior authorization requirements, and Medicare-based coverage criteria for durable medical equipment provided for members, including a special note on Automatic External Defibrillators (Life Vest). Applies to Longevity Health Plan of Colorado members and providers seeking coverage for DME.All longevityhealthplanofcolorado updates
- Coverage CriteriaClinical/Medical PolicyLower Extremity Invasive Diagnostic and Endovascular ProceduresThis policy governs prior authorization and medical necessity criteria for lower extremity peripheral artery revascularization services (endovascular procedures including PTA and stenting) for members of Longevity Health Plan of Colorado. It supplements and reiterates NCD 20.7 and LCD L35998 guidance.All longevityhealthplanofcolorado updates
- Coverage CriteriaClinical/Medical PolicySkin Substitute Grafts/Cellular and Tissue-Based Products (CTPs)This policy governs coverage criteria, documentation requirements, application limits, and product-specific indications for skin substitute grafts/CTPs used to treat chronic wounds (primarily diabetic foot ulcers and venous leg ulcers) for Longevity Health Plan of Colorado members.All longevityhealthplanofcolorado updates
- Coverage CriteriaClinical/Medical PolicySocial Needs Companion BenefitDefines medical necessity criteria and prior authorization requirements for Longevity Health Plan of Colorado's supplemental social needs companion benefit for members with acute behavioral or mental health needs who may benefit from short-term companionship services.All longevityhealthplanofcolorado updates
- Coverage CriteriaClinical/Medical PolicyWound Care DressingsThis policy governs prior authorization, documentation, and coverage criteria for Part B wound care surgical dressings used by Longevity Health Plan of Colorado beneficiaries, aligning requirements to LCD L33831 and applying across the states where the plan operates.All longevityhealthplanofcolorado updates
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Tool Description
Search Longevityhealthplanofcolorado 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.
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