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Tufts Health Plan Medical Policy Updates – December 2022
Click here to view the Tufts Health Plan Medical Policy Updates »
December 2022 Tufts Health Plan Medical Policy Updates:
- Absorbent Products
- Adult Medical Day Care for Tufts Health RITogether
- Anticonvulsant Medications
- Antidepressant Medications
- Anti-Obesity Medications
- Assisted Reproductive Technology Services
- Autism Services: Physical, Occupational and Speech Therapy for Members with Autism Spectrum Disorders
- Bariatric Surgery
- Behavioral Health Level of Care for Non-24 Hour/Intermediate/Diversionary Services
- Breast Cancer Index
- Cardiac Prior Authorization Program
- chiropractic
- Clinical Trials: Routine Costs
- Comprehensive Genomic Profiling with FoundationOne CDx or FoundationOne Liquid CDx to Guide Cancer Treatment in Patients with Advanced Cancer
- Continuity of Care Review for Members of Tiered or Limited Network Plans: Massachusetts
- Continuous Glucose Monitoring and Diabetes Management Devices
- Continuous Glucose Monitoring Systems – Dexcom G6 and FreeStyle Libre Systems Only
- Custom Fabricated Oral Appliances for Obstructive Sleep Apnea (OSA)
- Dental Implants
- Devices for the Management of Diabetes (Continuous Glucose Monitoring Systems, Artificial Pancreas Device Systems)
- ed-services
- Enteral Nutrition Products and Digestive Enzyme Cartridges for Tufts Health RITogether, Adults and Children
- Enteral Nutrition, Digestive Enzyme Cartridges and Special Medical Formulas for Tufts Health Together and Tufts Health Unify
- Extended Home Care Services for Tufts Health RITogether
- gastroenterology-payment-policy
- Genetic and Molecular Diagnostic Testing
- Glucagon Products
- Habilitative Services for Physical Therapy, Occupational Therapy and Speech Therapy
- High Cost Durable Medical Equipment (DME), Adaptive Strollers and Speech Generating Devices
- Home Health Care Services
- Home Health Care Services for Tufts Health Together, Tufts Health RITogether and Tufts Health Unify
- Hospice Services
- Hospice Services for Tufts Health Together, Tufts Health RITogether and Tufts Health Unify
- Human Leukocyte Antigen Genotyping
- Implantable Neurostimulator
- In-Home Palliative Care Services
- Inpatient Setting for Elective Total Joint Arthroplasty; Hip and Knee
- Joint Surgery Prior Authorization Program
- Level of Care, Inpatient (Medical/Surgical)
- Lower Limb Prostheses
- ltss-payment-policy
- Manual Wheelchairs
- Manual Wheelchairs for Tufts Health Together, Tufts Health RITogether and Tufts Health Unify
- Mobile Outpatient Cardiac Telemetry (MOCT)
- Noncovered Investigational Services
- Non-Insulin Antidiabetic Agents
- Orthognathic Surgery for Severe Oral-Maxillofacial Functional Disorders
- Osteogenesis Stimulators, Noninvasive
- Out-of-Network Coverage at the In-Network Level of Benefits (All Plans)
- Outpatient Out of Plan Continuity of Care Coverage for Behavioral Health
- Outpatient Physical Therapy, Occupational Therapy and Speech Therapy
- Power Operated Vehicles (POVs)
- Power Operated Vehicles (POVs) for Tufts Health Together, Tufts Health RITogether and Tufts Health Unify
- Power Wheelchairs
- Power Wheelchairs for Tufts Health Together, Tufts Health RITogether and Tufts Health Unify
- Pre-Operative Day Authorization
- Procedures for the Treatment of Benign Prostatic Hypertrophy (BPH)
- Procedures for the Treatment of Symptomatic Varicose Veins
- Pulmonary Rehabilitation: Inpatient
- Reconstructive and Cosmetic Surgery
- reconstructive-cosmetic
- Rehabilitative Services: Occupational Therapy
- Rehabilitative Services: Physical Therapy
- Rehabilitative Services: Speech Therapy
- Spinal Cord Stimulator (SCS) Insertion
- Step Therapy and Prior Authorization Guidelines
- Subcutaneous Implantable Cardioverter Defibrillator (S-ICD)
- Telehealth
- Temporary Total Artificial Heart System Bridge-to-Transplant
- Temporomandibular Joint (TMJ) Disorder Treatment
- Testosterone Replacement Therapies
- Transcranial Magnetic Stimulation (rTMS)
- Tufts Medicare Preferred HMO
- Upper Limb Prostheses
- UVB Home Units for Skin Disease
Click here to view the Tufts Health Plan Medical Policy Updates »
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