What insurance policy changes affect HCPCS A9611?

There are 7 tracked policy changes affecting HCPCS A9611, including updates from Humana, Michigan Medicaid - MDHHS, 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 A9611?

Payers that have issued tracked updates for HCPCS A9611 include: Humana, Michigan Medicaid - MDHHS, Blue Cross Blue Shield of Rhode Island.

How do I get notified when HCPCS A9611 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS A9611. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for HCPCS A9611?

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.

A9611 — Flurpiridaz f 18, diagnostic, 1 millicurie: Insurance Policy Changes

A9611 Insurance Policy Changes

HCPCS A9611 is officially defined as "Flurpiridaz f 18, diagnostic, 1 millicurie." HCPCS A9611 is referenced in 7 tracked payer policy changes from Humana, Michigan Medicaid - MDHHS, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS A9611 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

Cardiac Stress Testing - MEDICAID - MICHIGAN (New)

Humana·Effective Aug 26, 2026

Humana Medicaid Michigan has issued a new cardiac stress testing coverage policy (HUM-MI-2658-000) effective 08/26/2026 that establishes comprehensive medical necessity criteria for stress testing procedures. The policy covers CPT codes 78466, 78468, 78469 and HCPCS code A9611 (Flurpiridaz F-18) for specific cardiac indications including CAD diagnosis, heart failure evaluation, post-intervention assessment, viability testing, oncology risk stratification, and congenital heart disease evaluation. Billing teams must verify claims meet one of the listed clinical indications to ensure coverage and avoid denials.

A9611 Insurance Policy Changes

Cardiac Stress Testing - MEDICAID - FLORIDA (New)

Cardiac Stress Testing - MEDICAID - VIRGINIA (New)

Cardiac Stress Testing - MEDICAID - MICHIGAN (New)

MMP 25-14: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates

Additional HCPCS Level II Code Changes and Modifier Changes

Payment Policies

Cardiac Stress Testing - MEDICAID - SOUTH CAROLINA (New)