Reimbursement Policy Updates
Aug. 25, 2026
Reimbursement policies, formerly known as clinical payment and coding policies, describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10 coding for claims submitted as covered services. This information is a resource for our payment policies. It’s not intended to address all reimbursement-related issues. We regularly add and modify reimbursement policy positions as part of our ongoing policy review process.
The following policies were updated:
- RP016 Chiropractic Care Services, effective July 24, 2026
- RP043 Lactation Support Services, effective July 24, 2026
- RP021 Laboratory Panel Billing, effective Aug. 21, 2026
- RP031 Trauma Activation - Facility Services, effective Aug. 14, 2026
- RP035 Unlisted/Not Otherwise Classified Coding Policy, effective Aug. 14, 2026
- RP052 Robotic Assisted Surgery, effective Nov. 16, 2026
- RPLAB014 Prenatal Screening (Nongenetic), effective Dec. 4, 2026
- RPLAB032 Oral Cancer Screening and Testing, effective Dec. 4, 2026
- RPLAB045 Pathogen Panel Testing, effective Dec. 4, 2026
- RPLAB046 Biomarkers for Myocardial Infarction and Chronic Heart Failure, effective Dec. 4, 2026
- RPLAB049 General Inflammation Testing, effective Dec. 4, 2026
- RPLAB050 Urine Culture Testing for Bacteria, effective Dec. 4, 2026
- RPLAB056 Gamma-glutamyl Transferase Testing in Adults, effective Dec. 4, 2026
- RPLAB057 Coronavirus Testing in the Outpatient Setting, effective Dec. 4, 2026
- RPLAB061 Testing for Alpha-1 Antitrypsin Deficiency, effective Dec. 4, 2026
- RPLAB063 Identification of Microorganisms Using Nucleic Acid Probes, effective Dec. 4, 2026
- RPLAB071 Colorectal Cancer Screening, effective Dec. 4, 2026
CPT copyright 2025 American Medical Association. CPT is a registered trademark of the AMA.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.