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PAYER POLICY CHANGES

C9175 Insurance Policy Changes

HCPCS C9175 is officially defined as "Injection, treosulfan, 50 mg." HCPCS C9175 is referenced in 9 tracked payer policy changes from Indiana Medicaid (IHCP), Kansas Medicaid (KanCare), and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS C9175 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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REFERENCE DATA

Payers with rules4
Payers requiring prior auth4
  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

  • Centene · Effective December 31, 2025

    Prior authorization required

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

  • Community Health Plan of Imperial Valley · Effective December 31, 2025

    Prior authorization required

    Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does CalViva Health require prior authorization for C9175?

CalViva Health lists C9175 on CalViva Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Centene require prior authorization for C9175?

Centene lists C9175 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 Community Health Plan of Imperial Valley require prior authorization for C9175?

Community Health Plan of Imperial Valley lists C9175 on Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Coordinated Care require prior authorization for C9175?

Coordinated Care lists C9175 on Coordinated Care CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS C9175?

There are 9 tracked policy changes affecting HCPCS C9175, including updates from Indiana Medicaid (IHCP), Kansas Medicaid (KanCare), Blue Cross Blue Shield of Rhode Island. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS C9175?

Payers that have issued tracked updates for HCPCS C9175 include: Indiana Medicaid (IHCP), Kansas Medicaid (KanCare), Blue Cross Blue Shield of Rhode Island, Michigan Medicaid - MDHHS, Molina Healthcare, Arkansas Medicaid.

How do I get notified when HCPCS C9175 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS C9175. 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 C9175?

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 C9175

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for C9175 in one place.

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