March 20, 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:
- RP005 (formerly known as CPCP) Home Health Care Policy, effective March 9, 2026
- CPCPLAB044 Lyme Disease Testing, effective April 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.