Dec. 22, 2025
Clinical payment and coding policies describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10 coding for claims submitted as covered services. This information is a resource for our payment policies. It’s not intended to address all reimbursement-related issues. We regularly add and modify policy positions as part of our ongoing policy review process.
The following policies were updated:
- CPCP002 Inpatient/Outpatient Unbundling Policy – Facility, effective March 13, 2026
- CPCP006 Preventive Services Policy, effective Jan. 1, 2026
- CPCP008 Psychological and Neuropsychological Testing, effective March 2, 2026
- CPCP011 Applied Behavior Analysis, effective March 20, 2026
- CPCP020 Drug Testing, effective March 20, 2026
- CPCP024 Evaluation and Management Coding – Professional Provider, effective Feb. 23, 2026
- CPCP025 Corrected Claim Submissions, effective Dec. 1, 2025
- CPCP027 Inpatient Readmissions – Facility Services, effective Dec. 19, 2025
- CPCP030 Point-of-Care Ultrasound – POCUS Examination Policy, effective Dec. 19, 2025
- EIU Code List – (Supplement to CPCP028 – Non-Reimbursable Experimental, Investigational and/or Unproven Services)
View the policies.
CPT copyright 2024 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.