Medical policy updates
Effective August 1, 2025, CPT codes 0118U, 0508U, 0509U, 0540U, 81595, 0016M and 0288U keep their prior authorization requirement, and their medical criteria move to the online authorization tool for participating providers for Medicare Advantage plans and commercial products. Effective September 1, 2025, prior authorization is removed for CPT 81455 and 81456 for Medicare Advantage plans and commercial products, and these services will be covered. Effective October 1, 2025, 76 additional ICD-10 diagnosis codes are covered for CPT 0077U for Medicare Advantage plans and commercial products, and CPT 20975 is corrected to require prior authorization for Medicare Advantage plans.