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PAYER POLICY CHANGES

C9167 Insurance Policy Changes

HCPCS C9167 is officially defined as "Injection, adamts13, recombinant-krhn, 10 iu." No tracked policy changes reference HCPCS C9167 yet. New payer updates are added daily, so check back soon or create a free alert to be notified the moment a change affects this code.

No policies yet

No tracked policy changes match this filter yet. New policies are added daily.

Watch C9167

Get one email when a payer policy names C9167, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

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REFERENCE DATA

Payers with rules3
Payers requiring prior auth3
  • Fidelis Care · Effective November 1, 2026

    Prior authorization required

    Fidelis Care Metal-Level Products authorization grid

  • Centene · Effective December 31, 2025

    Prior authorization required

    Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does AmeriHealth Caritas require prior authorization for C9167?

AmeriHealth Caritas lists C9167 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does Centene require prior authorization for C9167?

Centene lists C9167 on Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Fidelis Care require prior authorization for C9167?

Fidelis Care lists C9167 on Fidelis Care Metal-Level Products authorization grid for exchange plans (list dated November 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS C9167?

No policy changes affecting HCPCS C9167 have been tracked yet. Check back as coverage expands.

Which payers have updated policy for HCPCS C9167?

No payer-specific updates have been tracked for HCPCS C9167 yet.

How do I get notified when HCPCS C9167 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS C9167. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for HCPCS C9167?

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.

See every payer rule for C9167

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for C9167 in one place.

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