• 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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456 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: Aug. 1, 2026 Last Revised: Jul. ...
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, 2025 Last Revised: Sep. ...
https://www.premera.com/medicalpolicies/1.03.04.pdf#search=policy
MEDICAL POLICY - 1.03.04 Powered Exoskeleton for Ambulation in Patients With Lower-Limb Disabilities BCBSA Ref. Policy: 1.03.04 Effective Date: Jun. 1, 2026 Last Revised: May 11, ...
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/11.01.525.pdf#search=policy
Policy: N/A Effective Date: Sep. 1, 2026 Last Revised: Jun. 16, 2026 Replaces: N/A RELATED ... criteria within this policy DO NOT apply to Indian Health Services (IHS) facilities. ...
https://www.premera.com/medicalpolicies/2.01.107.pdf#search=policy
MEDICAL POLICY - 2.01.107 Fractional Carbon Dioxide (CO2) Laser Ablation Treatment of Hypertrophic Scars or Keloids for Functional Improvement BCBSA Ref. Policy: 2.01.107 Effective ...
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: Jul. 1, ...
https://www.premera.com/medicalpolicies/5.01.615.pdf#search=policy
PHARMACY POLICY - 5.01.615 Pharmacologic Treatment of Chronic Non-Infectious Liver ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
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/1.01.529.pdf#search=policy
This policy explains when durable medical equipment is covered. Note: The Introduction section is for your general knowledge and is not to be taken as policy coverage criteria. The ...
https://www.premera.com/medicalpolicies/11.01.508.pdf#search=policy
below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ... not cover non-skilled home care.) This policy describes when home health care services ...
https://www.premera.com/medicalpolicies/3.03.03.pdf#search=policy
PHARMACY / MEDICAL POLICY - 3.03.03 Prescription Digital Therapeutics for Attention Deficit/Hyperactivity Disorder BCBSA Ref. Policy: 3.03.03 Effective Date: Jan. 1, 2026 Last ...
https://www.premera.com/medicalpolicies/3.03.523.pdf#search=policy
PHARMACY / MEDICAL POLICY - 3.03.523 Prescription Digital Health Diagnostic Aid for Autism Spectrum Disorder BCBSA Ref. Policy: 3.03.01 Effective Date: May 1, 2026 Last Revised: ...
https://www.premera.com/medicalpolicies/4.01.502.pdf#search=policy
MEDICAL POLICY - 4.01.502 Surgical Interruption of Pelvic Nerve Pathways for Chronic ... below to be directed to that section. POLICY CRITERIA | CODING | RELATED INFORMATION ...
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: Sep. 1, 2026 Last Revised: Aug. 10, 2026 Replaces: N/A RELATED MEDICAL POLICIES: ...
https://www.premera.com/medicalpolicies/5.01.544.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.544 Prostate Cancer Targeted Therapies Effective Date: ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | APPENDIX | REFERENCES | ...
https://www.premera.com/medicalpolicies/5.01.569.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.569 Pharmacotherapy of Type 1 and Type 2 Diabetes ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.570.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.570 Pharmacologic Treatment of Duchenne Muscular Dystrophy BCBSA Ref. Policy: 5.01.27 & 5.01.46 Effective Date: May 1, 2026 Last Revised: Apr. 27, ...
https://www.premera.com/medicalpolicies/5.01.608.pdf#search=policy
PHARMACY - 5.01.608 Pharmacologic Treatment of Postpartum Depression BCBSA Ref. Policy: ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS RELATED INFORMATION | EVIDENCE REVIEW | ...