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Mutual News June 2026 Newsletter
Medical Mutual of Ohio·Plastic Surgery, Pain Management, Oncology +10 more·Mutual News Newsletter
Effective date
Jun 16, 2026
We identified it
Jun 20, 2026
Summary
Medical Mutual has updated numerous medical policies, replacing MCG guidelines with InterQual subsets, adding new policies for procedures like PTNS and bioimpedance spectroscopy, removing several services from investigational/experimental lists, and adding high-cost specialty drugs requiring special reimbursement arrangements.
Action Required
By June 16, 2026: Billing team must update systems to reflect policy changes - remove investigational/experimental edits for multiple procedures including electromagnetic therapy, MRI-guided focused ultrasound, migraine surgery, bronchial thermoplasty, and others now covered. Add CPT 19370 to breast reconstruction edits and CPT 64624 to radiofrequency pain treatment. Contact network management for reimbursement agreements on new high-cost specialty drugs Q5151, Q5152, J9138, and J3590/C9399 before submitting claims. Review full policy details at Medmutual.com for complete coverage criteria changes.