Medical Policy and Coding Updates - November 2025
Premera HMO plans in Washington have changes from the November 2025 medical policy and coding update. Fifty Routine Test Management policies for laboratory services are effective February 6, 2026, and the notice says they are managed through claims edits for rule-based criteria and are not prior authorization. Other dated items include new medical necessity and prior authorization review for several coded services and Federal Employee Program prior authorization for certain drugs, all listed with an effective date of February 6, 2026.