Notices of material changes/amendments to contract — June 2024

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

• Notification of NCCI review of medically unlikely edits
• Implant — Facility Editing update
• Updates to Carelon Post-Acute Care Clinical Appropriateness Guidelines
• Carelon Medical Benefits Management, Inc. genetic testing code updates
• Expansion of Carelon Medical Benefits Management, Inc. programs
• Reimbursement policy update: Virtual Visits — Professional and Facility
• Reimbursement policy update: Laboratory and Venipuncture Services — Professional and Facility
• Clinical Criteria updates for specialty pharmacy