Learn how the Bridge Program applies to NYCE PPO, Large Group, and ASO plan members in 2026.
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Payment Integrity Policies
| Title | Download (PDF) |
|---|---|
| Annual Fee Schedule Updates – CMS and Medicaid | Download (PDF) |
| Claims Review Program | Download (PDF) |
| Coding Validation | Download (PDF) |
| CPT/HCPCS New Code Updates | Download (PDF) |
| Device, Implant and Skin Substitutes Coding Guidelines (Facilities) | Download (PDF) |
| Hospital Inpatient - Routine Supplies & Services | Download (PDF) |
| Laboratory Benefit Management Program | Download (PDF) |
| Medicaid State Directed Payments and Benchmark Rate Adjustments | Download (PDF) |
| Pre/Post Claims Payment Reviews | Download (PDF) |
| Sepsis Coding - Pre/Post Claims Review | Download (PDF) |