Asuris Medicare Advantage and its affiliated Plans use medical policies as guidelines for coverage decisions within the member’s written benefits. Below are summaries of recent changes to the Medicare Advantage medical policy manual. We have included the section and policy number for your convenience.
The complete Medicare Medical Policy Manual with detailed policies are available online at asuris.com/provider/library/policies-guidelines/ma-medical-policy.
Policy name | Summary of policy or change | Effective date | Section and policy number |
|---|---|---|---|
Added additional guidance for wheelchair accessories. | February 1, 2025 | Durable Medical Equipment #M-37 | |
New policy addresses the use of ablation of peripheral nerves to treat pain. | February 1, 2025 | Surgery #M-236 | |
Updated policy to remove retired Medicare guidance and add new billing and coding guidance. | November 1, 2024 | Durable Medical Equipment #M-78 | |
Updated policy to address only dual chamber leadless pacemakers. | November 1, 2024 | Surgery #M-217 | |
Expanded policy scope to include external lower extremity nerve stimulation for the treatment of restless leg syndrome. | October 1, 2024 | Durable Medical Equipment #M-83 | |
New Medicare policy to address lower extremity sensory prostheses. | October 1, 2024 | Durable Medical Equipment #M-95 | |
New policy to address amplitude-modulated radiofrequency electromagnetic fields (AM RF-EMF) for cancer treatment. | October 1, 2024 | Durable Medical Equipment #M-96 | |
| October 1, 2024 | Genetic Testing #M-64 | |
| October 1, 2024 | Genetic Testing #M-83 | |
New policy to address digital therapeutic products for gait training. | October 1, 2024 | Medicine #M-175.06 | |
Indicated that if no Medicare guidance is available, providers should refer to our commercial policy. | August 1, 2024 | Surgery #M-221 | |
Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Uncontrolled Hypertension | August 1, 2024 | Surgery #M-235 | |
Updated policy to address stimulation for nerve regeneration. | July 1, 2024 | Durable Medical Equipment #M-83 | |
Added five new CPT codes to policy and updated Medicare guidance. | July 1, 2024 | Genetic Testing #M-64 | |
Added several new tests and CPT codes to policy, with Medicare guidance when available. | July 1, 2024 | Genetic Testing #M-83 | |
Added codes related to 2024 Q3 code set update. | July 1, 2024 | Medicine #M-148 | |
Added codes related to 2024 Q3 code set update. | July 1, 2024 | Medicine #M-149 | |
Changed policy title from: Transurethral Water Vapor Thermal Therapy and Transurethral Water Jet Ablation (Aquablation) of the Prostate | July 1, 2024 | Surgery #M-210 | |
New Medicare Advantage policy addresses digital therapeutics for post-traumatic stress disorder and panic disorder, Freespira and NightWare. | May 1, 2024 | Medicine #M-175.05 | |
Changed policy title to align with Commercial medical policy; policy was previously titled Subcutaneous Tibial Nerve Stimiulation (STNS). | May 1, 2024 | Surgery #M-154 | |
| May 1, 2024 | Surgery #M-227 | |
Policy updated to include new Noridian LCD L39591 which provides limited coverage for external upper limb tremor stimulators for essential tremor. | April 7, 2024 | Durable Medical Equipment #M-83 | |
Updated to include intensive outpatient programs per Medicare Benefit Manual Chapter 6. | April 1, 2024 | Behavioral Health #M-20 | |
Policy updated to include new HCPCS codes for a pneumatic prosthetic knee (L5841) and the RevoFit System for socket volume adjustment (L5783). | April 1, 2024 | Durable Medical Equipment #M-18 | |
| April 1, 2024 | Durable Medical Equipment #M-89 | |
New policy that follows Commercial medical policy guidance. | April 1, 2024 | Durable Medical Equipment #M-94 | |
New policy addresses genetic testing for hereditary cancer risk, which was previously in M-GT64. | April 1, 2024 | Genetic Testing #M-02 | |
Removed tests related to cancer from policy, as these are not addressed in new policies M-GT02 (hereditary cancer risk testing) and M-GT83 (other cancer-related testing). | April 1, 2024 | Genetic Testing #M-64 | |
New policy specifically addressing genetic and molecular testing related to cancer diagnosis, prognosis, and treatment selection. | April 1, 2024 | Genetic Testing #M-83 | |
Updated the policy to add a new code effective 4/1/2024. | April 1, 2024 | Medicine #M-149 | |
Removed dermal filler codes from policy as this will be addressed through Pharmacy Policy. | April 1, 2024 | Surgery #M-12 | |
New Policy that points to Commercial policy SUR233 for coronary intravascular lithotripsy. | April 1, 2024 | Surgery #M-233 |
Policy name | Archive date | Medicare Manual section and policy # |
|---|---|---|
Radioembolization, Transarterial Embolization (TAE), and Transarterial Chemoembolization (TACE) | November 1, 2024 | Medicine #M-140 |