What insurance policy changes affect CPT 28308?

There are 6 tracked policy changes affecting CPT 28308, including updates from Harvard Pilgrim Health Care, Providence Health Plan, Health Net. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 28308?

Payers that have issued tracked updates for CPT 28308 include: Harvard Pilgrim Health Care, Providence Health Plan, Health Net.

How do I get notified when CPT 28308 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 28308. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 28308?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

28308 — A surgical cut made into the metatarsal bones in your foot to access and treat an underlying problem.: Insurance Policy Changes

28308 Insurance Policy Changes

CPT 28308, in plain terms, covers A surgical cut made into the metatarsal bones in your foot to access and treat an underlying problem. CPT 28308 is referenced in 6 tracked payer policy changes from Harvard Pilgrim Health Care, Providence Health Plan, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 28308 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

Special Alert March 2026 - Outpatient Surgical Site of Service Notice

Providence Health Plan·Effective May 11, 2026

Effective May 11, 2026, Providence Health Plan (Commercial Fully Insured Groups only) will now require medical necessity review for hospital outpatient surgical site of service (place of service 22) for knee arthroscopy, shoulder arthroscopy, and small joint surgery procedures. If medical policy criteria are not met for outpatient hospital setting, the procedure must be performed at an ASC instead. Providers without ASC access must submit signed attestation or note ASC unavailability on prior authorization requests.

28308 Insurance Policy Changes

Point32Health Medical Necessity Guideline updates

Special Alert March 2026 - Outpatient Surgical Site of Service Notice

Special Alert May 2026 UPDATE - Outpatient Surgical Site of Service Notice

Special Alert May 2026 UPDATE - Outpatient Surgical Site of Service Notice

Special Alert March 2026 - Outpatient Surgical Site of Service Notice

25-998 Streamlining Prior Authorization: Simplifying Processes for Better Efficiency