What insurance policy changes affect American Samoa providers?

This page tracks changes from major payers (including Medicaid managed care, commercial insurers, and Medicare Advantage plans) that explicitly apply to American Samoa. Changes include prior authorization updates, billing code additions or deletions, and reimbursement rate revisions.

How often are American Samoa policy changes updated?

Our scrapers run daily and publish new findings within 24 hours of detection. Each change includes an effective date where stated so you can prioritize what requires immediate action.

How do I get alerted to new American Samoa insurance policy changes?

Create a free alert on PolicyChanges.app and filter by state to American Samoa. You will get an email when new matching changes are detected: daily or weekly, your choice, on every plan.

PAYER POLICY CHANGES

American Samoa Insurance & Medicaid Policy Updates

American Samoa providers face a continuous stream of payer policy changes: coverage edits, prior authorization expansions, billing code revisions, and Medicaid reimbursement updates that affect day-to-day practice operations. This page surfaces every tracked policy change that explicitly names American Samoa, so your billing and compliance teams can act before the effective date, not after a claim denial.

Humana · Effective Aug 3, 2026High impact
Breast Excision and Mastectomy - Medicare Advantage (Revised)
Humana Medicare Advantage has updated its Breast Excision and Mastectomy policy (HUM-1254-009) effective 08/03/2026. This revised policy clarifies coverage criteria for breast lesion excisions (CPT 19120, 19125), partial mastectomies (CPT 19301, 19302), and gynecomastia mastectomy (CPT 19300) across multiple MAC jurisdictions. The policy establishes specific medical necessity criteria based on biopsy results, lesion characteristics, and anatomical considerations, and applies jurisdiction-specific Local Coverage Determinations (LCDs) for Medicare Administrative Contractors.
Humana · Effective Aug 3, 2026High impact
Benign Prostatic Hyperplasia Treatments - Medicare Advantage (Revised)
This is a comprehensive Medicare Advantage policy for Benign Prostatic Hyperplasia (BPH) treatments that became effective on August 3, 2026. The policy outlines coverage for multiple surgical and minimally invasive treatment modalities including TURP, laser therapies, temporary implanted devices, and stents, with specific coverage determinations varying by MAC jurisdiction. Billing teams must verify applicable MAC-specific LCDs and NCDs by geographic location before processing BPH treatment claims.
Humana · Effective Oct 1, 2026Medium impact
Noninvasive Tests for Hepatic Fibrosis - Medicare Advantage (Revised)
This is a Medicare Advantage policy update (effective 10/01/2026) covering noninvasive tests for hepatic fibrosis, including imaging-based tests (MRE, qMRA) and blood-based biomarker panels (ELF, FIB-4, FibroSure, LiverFASt, NIS4, OWLiver, TruD, HepQuantDuO). The policy establishes coverage determination criteria for these tests across multiple MAC jurisdictions. The document provided is incomplete and does not contain the full coverage determination criteria, medical necessity requirements, or specific billing code guidance needed for implementation.
Humana · Effective Oct 1, 2026Medium impact
Low Frequency, Noncontact, Nonthermal Ultrasound for Wound Care - Medicare Advantage (Revised)
This is a revised Medicare Advantage policy for low frequency, noncontact, nonthermal ultrasound (MIST Therapy) for wound care, effective October 1, 2026. The policy clarifies medical necessity criteria across multiple MAC jurisdictions, requiring that standard wound care demonstrate no improvement or be contraindicated before this therapy is covered. Billing teams must ensure claims include proper documentation of failed standard care and route requests through applicable regional MACs.
Humana · Effective Aug 3, 2026Medium impact
Liquid Biopsy - Medicare Advantage (Revised)
Humana Medicare Advantage has updated its Liquid Biopsy coverage policy (Policy HUM-1151-014), effective 08/03/2026. This policy establishes coverage criteria for liquid biopsy tests (blood-based biomarker analysis for cancer detection and treatment monitoring) across multiple jurisdictions under Medicare Administrative Contractors. The policy requires medical necessity documentation and adherence to MAC-specific Local Coverage Determinations, with coverage determined through analytical/clinical validity standards and DEX Registry evaluation where CMS guidance is absent.
Humana · Effective Jul 1, 2026Medium impact
Coronary CT Angiography, Fractional Flow Reserve with CT and Adjunctive Testing - Medicare Advantage (Revised)
This is a Medicare Advantage policy revision (effective 07/01/2026) for Coronary CT Angiography, Fractional Flow Reserve with CT, and adjunctive cardiac testing. The policy establishes that Humana follows applicable Local Coverage Determinations (LCDs) by MAC jurisdiction for CCTA (CPT 75574) and FFRCT (CPT 75580), with specific LCD guidance for each geographic region. Billing teams must ensure prior authorization and medical necessity documentation align with the applicable LCD in the patient's service area.

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Breast Excision and Mastectomy - Medicare Advantage (Revised)

Benign Prostatic Hyperplasia Treatments - Medicare Advantage (Revised)

Noninvasive Tests for Hepatic Fibrosis - Medicare Advantage (Revised)

Low Frequency, Noncontact, Nonthermal Ultrasound for Wound Care - Medicare Advantage (Revised)

Liquid Biopsy - Medicare Advantage (Revised)

Coronary CT Angiography, Fractional Flow Reserve with CT and Adjunctive Testing - Medicare Advantage (Revised)