Special Alert October 2025 - Electrolysis Documentation Requirements

Previously due 12/1/2025 (date passed; verify current applicability) (now historical): Billing team should have implemented documentation collection procedures for electrolysis claims submitted by providers or member reimbursement requests on Commercial and Medicare plans. Verify whether current documentation protocols include all five required elements (A–E): diagnosis, WPATH SOC-8 alignment statement, clinical rationale, treatment plan with session counts, and treatment area description. Confirm whether the practice has retained these requirements and whether any superseding guidance from Providence Health Plan has been issued since the 10/1/2025 publication date. Note that this requirement does not apply to Providence OHP members. Contact PHPMedicalPolicyInquiry@providence.org for clarification on current policy status.