Feb. 23, 2026
Reimbursement policies, formerly known as 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 reimbursement policy positions as part of our ongoing policy review process.
The following policies were updated:
- CPCP041 Sepsis Policy, effective April 30, 2026
- CPCPLAB067 Testing of Homocysteine Metabolism-Related Conditions, effective May 1, 2026
- CPCPLAB003 Vitamin D, effective May 1, 2026
- CPCPLAB008 Diagnostic Testing of Iron, effective May 1, 2026
- CPCPLAB009 Testosterone, effective May 1, 2026
- CPCPLAB010 Vitamin B12 and Methylmalonic Acid Testing, effective May 1, 2026
- CPCPLAB023 Diagnosis of Idiopathic Environmental Intolerance, effective May 1, 2026
- CPCPLAB028 Immune Cell Function Assay, effective May 1, 2026<
- CPCPLAB038 Urinary Tumor Markers for Bladder Cancer, effective May 1, 2026
- CPCPLAB064 Nerve Fiber Density Testing, effective May 1, 2026
- CPCPLAB069 Immunohistochemistry, effective May 1, 2026
CPT copyright 2025 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.