• Medical Policies

    Premera offers access to more than 300 medical policies online. Since we’re continually updating these pages, we encourage you to visit often. The policies are in Adobe PDF format. Individual plans use different medical policies. View individual plan medical policies and also View our HMO medical policies.

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378 results found for policy
https://www.premera.com/medicalpolicies/7.01.85.pdf#search=policy
MEDICAL POLICY - 7.01.85 Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures BCBSA Ref. Policy: 7.01.85 Effective Date: July 1, 2024 Last Revised: June ...
https://www.premera.com/medicalpolicies/7.01.92.pdf#search=policy
MEDICAL POLICY - 7.01.92 Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bone BCBSA Ref. Policy: 7.01.92 Effective Date: Oct. 1, 2024 Last Revised: Sept. ...
https://www.premera.com/medicalpolicies/2.04.152.pdf#search=policy
MEDICAL POLICY - 2.04.152 Maternal Serum Biomarkers for Prediction of Adverse Obstetric Outcomes BCBSA Ref. Policy: 2.04.152 Effective Date: May 1, 2024 Last Revised: Jan. 1, 2025 ...
https://www.premera.com/medicalpolicies/5.01.42.pdf#search=policy
MEDICAL POLICY - 5.01.42 Gene Therapies for Thalassemia BCBSA Ref. Policy: 5.01.42 Effective Date: June 1, 2024 Last Revised: Jan. 1, 2025 Replaces: N/A RELATED MEDICAL POLICIES: ...
https://www.premera.com/medicalpolicies/5.01.572.pdf#search=policy
PHARMACY POLICY - 5.01.572 Coverage Criteria for Excluded and Non-Formulary Drugs ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.573.pdf#search=policy
PHARMACY POLICY - 5.01.573 Pharmacotherapy of Perinatal/Infantile and Juvenile-Onset ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.586.pdf#search=policy
MEDICAL POLICY - 5.01.586 Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders BCBSA Ref. Policy: 5.01.16 Effective Date: Feb. 1, ...
https://www.premera.com/medicalpolicies/5.01.618.pdf#search=policy
MEDICAL / PHARMACY POLICY - 5.01.618 Selective Estrogen Receptor Modulators and Down ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.620.pdf#search=policy
MEDICAL POLICY - 5.01.620 Vascular Endothelial Growth Factor (VEGF) Receptor Inhibitors ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.632.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.632 Pharmacologic Treatment of Bladder Cancer Effective ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.636.pdf#search=policy
PHARMACY POLICY - 5.01.636 Chronic Hepatitis B Antiviral Therapy Effective Date: July 1, ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.642.pdf#search=policy
MEDICAL POLICY - 5.01.642 Gene Therapies for Rare Diseases BCBSA Ref. Policy: 5.01.49 Effective Date: Aug. 1, 2024 Last Revised: July 9, 2024 Replaces: N/A RELATED MEDICAL ...
https://www.premera.com/medicalpolicies/5.01.647.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.647 Medical Necessity Criteria for Custom Incentive and ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/6.01.68.pdf#search=policy
MEDICAL POLICY - 6.01.68 Irreversible Electroporation of Tumors Located in the Liver, Pancreas, Kidney, or Lung BCBSA Ref. Policy: 6.01.68 Effective Date: Jan. 1, 2025 Last ...
https://www.premera.com/medicalpolicies/7.01.563.pdf#search=policy
MEDICAL POLICY - 7.01.563 Ablative Treatments for Occipital Neuralgia, Chronic Headaches, ... below to be directed to that section. POLICY CRITERIA | CODING | RELATED INFORMATION ...
https://www.premera.com/medicalpolicies/7.01.574.pdf#search=policy
MEDICAL POLICY - 7.01.574 Implantable Peripheral Nerve Stimulation for the Treatment of Chronic Pain and Other Conditions BCBSA Ref. Policy 1.01.31, 7.01.29, 7.01.106 Effective ...
https://www.premera.com/medicalpolicies/7.01.587.pdf#search=policy
MEDICAL POLICY - 7.01.587 Open and Thoracoscopic Approaches to Treat Atrial Fibrillation and Atrial Flutter (Maze and Related Procedures) BCBSA Ref. Policy: 7.01.14 Effective Date: ...
https://www.premera.com/medicalpolicies/10.01.503.pdf#search=policy
below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ... This policy explains some of the circumstances when anesthesia may be covered by a ...
https://www.premera.com/medicalpolicies/11.01.523.pdf#search=policy
Feb. 1, 2025* Last Revised: Jan. 27, 2025 Replaces: N/A *This policy has been revised. ... Medical Necessity criteria within this policy DOES NOT apply to Alaska fully- insured ...
https://www.premera.com/medicalpolicies/11.01.523_2025-05-06.pdf#search=policy
Infusion Drugs and Biologic Agents Effective Date: May 6, 2025* Last Revised: Jan. 27, 2025 Replaces: N/A *This policy has been updated. Click here to view the current policy. ...