What insurance policy changes were tracked in 2025?

In 2025 we tracked 145 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 2025 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 2025 date range.

Insurance Policy Changes in 2025: Full Archive

Medium impact

2025 November Network Connection

Presbyterian Health Plan·Identified Nov 1, 2025

This November 2025 Presbyterian Network Connection is a multi-topic provider newsletter covering quality measure compliance (blood pressure control), required provider education events, wellness program resources, claims submission best practices, and Medicare Star Ratings guidance. Key billing-relevant items include reminders to document compliant blood pressure readings for HEDIS measures, proper electronic claims submission procedures, and upcoming changes to blood pressure quality measures. No immediate billing code or reimbursement changes are mandated.

Upcoming Changes to Prior Authorization Process for Physician-Administered Drugs – Effective January 1, 2026

February 2026 Drug List Change Notification (Commercial)

Thank You for Your Care and Commitment

When a natural disaster strikes, Regence is here to support your care needs

Prior authorization changes for February 1, 2026 – Medicare and Medicaid

January 2026 Community Solutions (Medicaid) formulary and coverage policies notification

Bennett Lumber maintains a dedicated workforce with help from Regence health plans

Prior Authorization Submission Help and Tips

Our health plans’ coverage of hepatitis B vaccinations remains unchanged

Authorization Updates - Effective Dec 2025, Jan 2026, and Mar 2026

Coverage for Home Sleep Study (Proc Codes 95800, 95801, and 95806)

Continued access to care through St. Charles & Salem Health for Commercial and Medicare Members

Identification of Microorganisms Using Nucleic Acid Probes (2.04.10)

Special Alert December 2025 - Medicaid Benefit: Complex Rehab Technology (CRT) Repair at Providence Health Plan

Rib Remodeling and Clavicle Shortening (BSC7.21)

Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders (2.04.102)

Special Alert December 2025 - Taxonomy Requirements

Medica Provider News: December 2025

Provider Chat Update: 24/7 Auth Status Check Is Now Live

Continued access to care through St. Charles Health System

Fall 2025 Authorization Updates

REVISED: 2025 Quarter 4 Healthcare Common Procedure Coding System Level II (HCPCS) Code and Current Procedural Terminology (CPT) Code Conversion

Medicaid and Commercial Prior Authorization Changes

Authorization Updates - Effective February 1, 2026

Medical Association and Blue Cross and Blue Shield of Alabama Announce Patient Centered Enhancements to Prior Authorization Process

New Coverage for B4100 U1 – SIMPLY THICK FOOD THICKENER ORAL - CONCENTRATE/1 OZ

Change to Prior Authorization Process for Physician-Administered Drugs – Effective January 1, 2026

Chromosomal Microarray Testing for the Evaluation of Pregnancy Loss (2.04.122)

Gene Expression Profile Testing and Circulating Tumor DNA Testing for Predicting Recurrence in Colon Cancer (2.04.61)

Noninvasive Techniques for the Evaluation and Monitoring of Patients With Chronic Liver Disease (2.04.41)

Germline Genetic Testing for Hereditary Breast/Ovarian Cancer Syndrome and Other High-Risk Cancers (BRCA1, BRCA2, PALB2) (2.04.02)

Genetic Testing for Heterozygous Familial Hypercholesterolemia (2.04.139)

Behavioral Health Treatment for Autism Spectrum Disorder or Pervasive Developmental Disorder (BSC3.01)

Genetic Testing for FMR1 Variants (Including Fragile X Syndrome) (2.04.83)

Gene Expression Profiling for Cutaneous Melanoma (2.04.146)

Use of Common Genetic Variants (Single Nucleotide Variants) to Predict Risk of Nonfamilial Breast Cancer (2.04.63)

Genetic Testing for Statin-Induced Myopathy (2.04.96)

Genetic Testing for Hereditary Hearing Loss (2.04.87)

Somatic Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment in Non-Small-Cell Lung Cancer (EGFR, ALK, BRAF, ROS1, RET, MET, KRAS, NTRK) (2.04.45)

Molecular Testing in the Management of Pulmonary Nodules (2.04.142)

Genetic Testing for Marfan Syndrome, Thoracic Aortic Aneurysms and Dissections, and Related Disorders (2.04.129)

Multibiomarker Disease Activity Blood Test for Rheumatoid Arthritis (2.04.119)

Liposuction for Lipedema and Lymphedema (7.01.169)

Special Alert November 2025 - 2026 Outpatient Site of Service

Medica Provider News: November 2025

Carrier Screening for Genetic Diseases (2.04.107)

Baroreflex Stimulation Devices (8.01.57)

Genetic Testing for Duchenne and Becker Muscular Dystrophy (2.04.86)

2025 November Network Connection

Authorization Updates - Effective January 1, 2026