What insurance policy changes were tracked in 2024?

In 2024 we tracked 9 policy changes across major U.S. health insurance payers. Changes include prior authorization rule updates, billing-code coverage modifications, fee schedule revisions, and plan-type policy changes.

How do I find 2024 policy changes for my specialty or state?

Use the related-hub links below the list to filter by provider, state, or specialty. You can also browse the full /changes feed and use pagination to reach the 2024 date range.

Insurance Policy Changes in 2024

All insurance policy changes we tracked in 2024. Each entry is AI-summarized with an impact rating and linked billing codes so you can quickly assess what matters to your practice.

Low impact
2024 November Network Connection
Presbyterian Health Plan·Identified Nov 1, 2024
This is a Presbyterian November 2024 provider newsletter containing multiple informational updates and program announcements, including CAHPS survey preparation guidance, wellness program referral pathways, opioid use disorder pharmacotherapy treatment standards (180-day minimum), cybersecurity scam alerts, and preventive health resources. No billing code changes, coverage modifications, or prior authorization requirement changes are implemented.
High impact
Presbyterian Will Update Its Medical Policy Manual and Prior Authorization Guide on Nov. 1, 2024
Presbyterian Health Plan·Effective Nov 1, 2024
Presbyterian Health Plan is updating its Medical Policy Manual and Prior Authorization Guide effective November 1, 2024, adding new procedures, modifying existing ones, and retiring three procedures (Autologous Chondrocyte Implantation, Meniscal Allograft Transplant, Thoracic Spinal Surgeries, and Unicompartmental Knee Replacement). Billing teams must verify prior authorization requirements for all affected procedures using Presbyterian's updated resources and tools.
High impact
Presbyterian Will Update Its Medical Policy Manual and Prior Authorization Guide on Oct. 1, 2024
Presbyterian Health Plan·Effective Oct 1, 2024
Presbyterian Health Plan is updating its Medical Policy Manual and Prior Authorization Guide effective October 1, 2024, adding and modifying prior authorization requirements for 18 procedures/services including new coverage for lymphedema and lipedema surgical treatment, bariatric surgery for pediatric patients, genetic/genomic testing, and various other procedures. Billing teams must verify prior authorization requirements for all affected procedures using Presbyterian's online tools before claims submission.
Medium impact
2024 September Network Connection
Presbyterian Health Plan·Identified Sep 1, 2024
Presbyterian's September 2024 Network Connection newsletter contains a regulatory update to CPT code +99417 (prolonged E/M services). The revision clarifies that the 15-minute initial time unit for +99417 can only be added once the primary E/M code's time threshold is exceeded by 15 minutes, and +99417 should not be reported for any time unit less than 15 minutes. This affects how providers bill for prolonged office visits and consultations.
Medium impact
2024 July Network Connection
Presbyterian Health Plan·Effective Jul 1, 2024
Presbyterian Insurance has rebranded New Mexico Medicaid Managed Care from 'Centennial Care' to 'Turquoise Care' effective July 1, 2024. Member ID numbers remain unchanged, but new ID cards will be mailed. New covered services (including chiropractic) are being added. The state regulatory body changed from New Mexico Human Services Department (HSD) to New Mexico Health Care Authority (HCA).
High impact
Presbyterian Will Update Its Medical Policy Manual and Prior Authorization Guide on May 1, 2024
Presbyterian Health Plan·Effective May 1, 2024
Presbyterian Health Plan is updating its Medical Policy Manual and Prior Authorization Guide effective May 1, 2024, adding and/or modifying prior authorization requirements for 24 procedures and services. This includes two new commercial policies (Clinical Trials Routine Patient Care Costs and Specialized Specimen Procedures) and updates to existing policies across multiple clinical areas. Billing teams must review the detailed updates document and adjust prior authorization workflows accordingly.
High impact
2024 May Network Connection
Presbyterian Health Plan·Effective May 1, 2024
Presbyterian has published a May 2024 provider newsletter containing multiple updates: (1) alternative claims submission methods and clearinghouses due to the Change Healthcare cyberattack affecting claims processing; (2) launch of the new PROVIDERConnect provider portal with streamlined eligibility, authorization, and claims search capabilities; and (3) updates to provider training requirements and new member incentive programs including the Pregnancy Passport program. The most critical item for billing teams is the immediate availability of alternative claims submission pathways to address ongoing Change Healthcare disruptions.
Medium impact
2024 March Network Connection
Presbyterian Health Plan·Effective Jan 1, 2024
Presbyterian issued a March 2024 provider newsletter containing multiple updates: (1) Weight management programs (Path for Wellness) are now available at no cost to Centennial Care members with new referral pathways; (2) Hospice Value-Based Insurance Design program ended effective January 1, 2024, requiring hospice claims for new enrollees to route to Original Medicare instead of Presbyterian Medicare Advantage plans; (3) Medicaid/CHIP benefits renewal processes have changed post-COVID emergency, requiring active member renewal and affecting claims processing; (4) Multiple provider training events are mandatory or recommended throughout 2024.
Medium impact
2024 January Network Connection
Presbyterian Health Plan·Effective Jan 1, 2024
Presbyterian has released updated 2024 Practitioner and Provider Manuals with new guidelines for prior authorization, medical policies, formularies, and utilization management. Additionally, providers must verify directory information every 90 days by April 1, 2024 (federal No Surprises Act requirement), and Presbyterian has expanded its Optum Care Network partnership effective January 1, 2024, which affects Medicare Advantage authorization workflows. A new Unite Us closed-loop referral system is also available at no cost for connecting members to community resources.

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2024 November Network Connection

Presbyterian Will Update Its Medical Policy Manual and Prior Authorization Guide on Nov. 1, 2024

Presbyterian Will Update Its Medical Policy Manual and Prior Authorization Guide on Oct. 1, 2024

2024 September Network Connection

2024 July Network Connection

Presbyterian Will Update Its Medical Policy Manual and Prior Authorization Guide on May 1, 2024

2024 May Network Connection

2024 March Network Connection

2024 January Network Connection