Reimbursement Policies

Reimbursement Policies are listed in alphabetical order.


A back to top Download (PDF)
After Hours and Weekend Care Download (PDF)
Anesthesia Reimbursement Policy Download (PDF)
Assistant at Surgery – Modifiers 80/81/82 and AS (Commercial) Download (PDF)
Cback to top Download (PDF)
Coding Edits Policy (Commercial and Medicare) Download (PDF)
Co-Surgeon/Team Surgeon-Modifiers 62/66 Download (PDF)
COVID-19 Vaccine and Monoclonal Antibody Infusions Policy - Revised May 2021 Download (PDF)
Dback to top Download (PDF)
Daily Maximum Units (Commercial/Medicare) Download (PDF)
Diagnosis Code Guidelines: Manifestation/Secondary Diagnosis Codes Download (PDF)
Discarded Drugs/Biologicals – Modifier JW (Commercial) Download (PDF)
Discontinued Procedures – Modifiers 53, 73 & 74 (Commercial) Download (PDF)
Eback to top Download (PDF)
E/M Supplemental Reimbursement Policy 2021 Update - New 1/01/2021 Download (PDF)
Mback to top Download (PDF)
Mid-Level Practitioner Reimbursement Policy (Commercial) Download (PDF)
Modifier SU – Procedure Performed in Physician’s Office (Commercial) Download (PDF)
Modifier Reference Policy (Commercial) Download (PDF)
Modifier Reference Policy (Commercial)– effective 9/1/2021 Download (PDF)
Nback to top Download (PDF)
National Drug Code (NDC) Requirements for Drug Claims - New 4/19/2021 Download (PDF)
Never Events/Adverse Events & Serious Reportable Events (Commercial) Download (PDF)
Oback to top Download (PDF)
Ophthalmology Reimbursement Policy Download (PDF)
Pback to top Download (PDF)
Preventive Health Services for your patients (Medicare) Download (PDF)
Prolonged Services (Commercial and Medicare) - New 1/1/2021 Download (PDF)
Rback to top Download (PDF)
Revenue Codes Requiring Detailed Coding (Commercial) - New 2/01/2021 Download (PDF)
Sback to top Download (PDF)
Split Surgical Care (Modifiers 54/55/56) (Commercial) Download (PDF)