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Provider Policy Updates | July 2026
Effective date
Not stated in the notice
Identified
Sep 29, 2026
Summary
Select Health's July 2026 provider bulletin added one new coding policy (Liposomal Bupivacaine, Policy #CR-109) and revised 14 medical policies. The revisions add or clarify coverage criteria for genetic and tumor testing, varicose vein procedures, intrauterine fetal surgery, and Baha Softband use in children 5 years of age and younger, and the PrismRA test is listed as excluded from coverage. Select Health also states that peripheral nerve stimulation for peripheral neuropathies is investigational/experimental and not covered.
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What to do
Action · 7 steps
01Already effective June 1, 2026: Genetic testing policies #240, #289, #385, #438, #510, #530, #538, #544, #586, #594, #600, #666, #678 and #680 were archived, and claims associated with them are now evaluated under new Select Health genetic testing policies that use Concert-adopted criteria.
02Already effective July 1, 2026: Medical policy #160 (Pectus Excavatum Surgery) was archived, and the CPT codes listed for it are covered without review.
03Already effective August 1, 2026: For medical policies #622, #557, #389, #648, #654, #609, #595 and #626, an additional requirement applies alongside the existing requirements for approval of attempts at conservative therapy.
04Under #626, the source requires a minimum of 12 physical therapy or chiropractic visits treating the area that requires the intervention within a 6-month period, performed within the previous year, with at least four recommended to be in person; after 6 visits, additional therapy is not required if contraindicated or not recommended by the physical or chiropractic therapist; and documentation submitted by a physical therapist must include the evaluation, treatment plan, expectations for improved outcomes, and duration of therapy.
05Already effective August 1, 2026: Stop billing peripheral nerve stimulation for peripheral neuropathies to Select Health, since it is considered investigational/experimental.
06Billing team: Verify that every billed service is within the licensed scope of practice of the provider who performs it, because benefit coverage does not override scope-of-practice requirements, and services outside scope may be denied as not covered for that provider type.
07This is ; check current applicability with Select Health before acting.
Original notice
Provider Policy Updates | July 2026
selecthealth.org · Always check the source before changing claims.
Related changes
See all SelectHealth changes →Provider Policy Updates | May 2026MediumEffective Jun 1, 2026 · Policy BulletinProvider Policy Updates | August 2026MediumEffective Sep 1, 2026 · Policy BulletinProvider Policy Updates | March 2026LowNo effective date · CodingProvider Policy Updates September 2026HighNo effective date · Policy BulletinBrowse every SelectHealth change in the policy list