New Hampshire Department Of Health And Human Services Coverage Criteria
- New Hampshire Department Of Health And Human Services prior authorization
- All New Hampshire Department Of Health And Human Services policy updates
Latest New Hampshire Department Of Health And Human Services coverage criteria updates10
- Coverage CriteriaClinical/Medical PolicyCasgevy (exagamglogene autotemcel) CriteriaThis policy governs New Hampshire Medicaid Fee-for-Service coverage and authorization of Casgevy for patients aged 12 years and older with sickle cell disease and recurrent vaso-occlusive crises or transfusion-dependent beta-thalassemia. Coverage requires fulfillment of all applicable general and disease-specific clinical criteria.All New Hampshire Department of Health and Human Services updates
- Coverage CriteriaClinical/Medical PolicyElevidys (delandistrogene moxeparvovec-rokl) Coverage CriteriaThis policy governs prior authorization and coverage of Elevidys for New Hampshire Medicaid Fee-for-Service beneficiaries with Duchenne muscular dystrophy. Coverage requires all specified clinical, laboratory, treatment, and monitoring criteria.All New Hampshire Department of Health and Human Services updates
- Coverage CriteriaClinical/Medical PolicyEncelto (revakinagene taroretcel-lwey) CriteriaThis policy governs prior authorization for Encelto for adults with idiopathic macular telangiectasia type 2 (MacTel). Coverage requires detailed ocular-disease, treatment-safety, monitoring, and prior-treatment criteria.All New Hampshire Department of Health and Human Services updates
- Coverage CriteriaClinical/Medical PolicyKebilidi (eladocagene exuparvovec-tneq) Coverage CriteriaThis policy governs prior authorization coverage for Kebilidi under the New Hampshire Medicaid Fee-for-Service Program for adult and pediatric patients with aromatic L-amino acid decarboxylase deficiency, subject to specified clinical and treatment criteria.All New Hampshire Department of Health and Human Services updates
- Coverage CriteriaClinical/Medical PolicyLenmeldy (atidarsagene autotemcel) Coverage CriteriaThis policy governs prior authorization and medical necessity requirements for Lenmeldy gene therapy under the New Hampshire Medicaid Fee-for-Service Program for children with specified presymptomatic or early symptomatic forms of metachromatic leukodystrophy.All New Hampshire Department of Health and Human Services updates
- Coverage CriteriaClinical/Medical PolicyRoctavian™ (valoctocogene roxaparvovec-rvox) CriteriaNew Hampshire Medicaid Fee-for-Service prior authorization and coverage criteria for a single lifetime dose of Roctavian in adults with severe congenital hemophilia A.All New Hampshire Department of Health and Human Services updates
- Coverage CriteriaClinical/Medical PolicySkysona (elivaldogene autotemcel) Coverage CriteriaThis policy governs prior authorization and coverage of Skysona (elivaldogene autotemcel) for New Hampshire Medicaid fee-for-service beneficiaries. It applies to boys aged 4 through 17 years with early, active cerebral adrenoleukodystrophy who meet specified clinical, laboratory, infection-screening, and treatment-planning requirements.All New Hampshire Department of Health and Human Services updates
- Coverage CriteriaClinical/Medical PolicySpravato (esketamine) Coverage CriteriaNew Hampshire Medicaid Fee-for-Service prior authorization, renewal, authorization duration, and quantity limits for Spravato nasal spray in adults with treatment-resistant depression or major depressive disorder with acute suicidal ideation or behavior.All New Hampshire Department of Health and Human Services updates
- Coverage CriteriaClinical/Medical PolicyWaskyra (etuvetidigene autotemcel) Coverage CriteriaThis policy governs prior authorization and coverage of Waskyra for eligible pediatric patients and adults with Wiskott-Aldrich Syndrome under the New Hampshire Medicaid Fee-for-Service Program. Coverage requires all clinical, transplant eligibility, safety, monitoring, and treatment-use criteria to be satisfied.All New Hampshire Department of Health and Human Services updates
- Coverage CriteriaClinical/Medical PolicyZynteglo (betibeglogene autotemcel) Coverage CriteriaNew Hampshire Medicaid Fee-for-Service coverage and prior authorization for Zynteglo in eligible adults and pediatric patients with transfusion-dependent beta thalassemia; coverage requires clinical, safety, treatment-preparation, and monitoring criteria and is limited to one treatment course.All New Hampshire Department of Health and Human Services updates
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Tool Description
Search New Hampshire Department Of Health And Human Services 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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