https://www.premera.com/medicalpolicies/7.01.170.pdf#search=policy
MEDICAL POLICY - 7.01.170 Laser Interstitial Thermal Therapy for Neurological Conditions BCBSA Ref. Policy: 7.01.170 Effective Date: Mar. 1, 2025 Last Revised: Feb. 10, 2025 ...
https://www.premera.com/medicalpolicies/8.01.15.pdf#search=policy
MEDICAL POLICY - 8.01.15 Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma BCBSA Ref. Policy: 8.01.15 Effective Date: Apr. 1, 2025 ...
https://www.premera.com/medicalpolicies/8.01.52.pdf#search=policy
MEDICAL POLICY - 8.01.52 Orthopedic Applications of Stem Cell Therapy (Including Allografts and Bone Substitutes Used with Autologous Bone Marrow) BCBSA Ref. Policy: 8.01.52 ...
https://www.premera.com/medicalpolicies/1.01.27.pdf#search=policy
MEDICAL POLICY - 1.01.27 Electrical and Electromagnetic Stimulation for the Treatment of Arthritis BCBSA Ref. Policy: 1.01.27 Effective Date: Jun. 1, 2025 Last Revised: May 12, ...
https://www.premera.com/medicalpolicies/2.04.125.pdf#search=policy
MEDICAL POLICY - 2.04.125 Proteomic Testing for Systemic Therapy in Non-Small Cell Lung Cancer BCBSA Ref. Policy: 2.04.125 Effective Date: Feb. 1, 2025 Last Revised: Jan. 13, 2025 ...
https://www.premera.com/medicalpolicies/5.01.549.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.549 Off-Label Use of Drugs and Biologic Agents Effective ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.571_2025-10-03.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.571 C3 and C5 Complement Inhibitors BCBSA Ref. Policy: 5.01.39 Effective Date: Oct. 3, 2025* Last Revised: Jun. 10, 2025 Replaces: N/A *View the ...
https://www.premera.com/medicalpolicies/5.01.576_2025-10-03.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.576 Drugs for Rare Diseases BCBSA Ref. Policy: 5.01.37 and 5.01.40 Effective Date: Oct. 3, 2025* Last Revised: Jun. 10, 2025 Replaces: N/A *This ...
https://www.premera.com/medicalpolicies/5.01.633.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.633 Intraarticular Corticosteroids Effective Date: May ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.651_2025-10-03.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.651 Pharmacologic Treatment of Parkinson's Disease Effective Date: Oct. 3, 2025* Last Revised: Jun. 10, 2025 Replaces: N/A *This policy has been ...
https://www.premera.com/medicalpolicies/7.01.171.pdf#search=policy
MEDICAL POLICY - 7.01.171 Remote Electrical Neuromodulation for Migraines BCBSA Ref. Policy: 7.01.171 Effective Date: Jan. 1, 2025 Last Revised: Dec. 9, 2024 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/7.01.174.pdf#search=policy
PHARMACY / MEDICAL POLICY - 7.01.174 Stationary Ultrasonic Diathermy Devices BCBSA Ref. Policy: 7.01.174 Effective Date: Apr. 1, 2025 Last Revised: Mar. 10, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/1.01.537.pdf#search=policy
MEDICAL POLICY - 1.01.537 Low Intensity Pulsed Ultrasound Fracture Healing Device BCBSA Ref. Policy: 1.01.05 Effective Date: Jul. 1, 2025 Last Revised: Jun. 23, 2025 Replaces: ...
https://www.premera.com/medicalpolicies/2.04.119.pdf#search=policy
MEDICAL POLICY - 2.04.119 Multibiomarker Disease Activity Blood Test for Rheumatoid Arthritis BCBSA Ref. Policy: 2.04.119 Effective Date: Sept. 1, 2024 Last Revised: Aug. 12, 2024 ...
https://www.premera.com/medicalpolicies/2.04.521.pdf#search=policy
MEDICAL POLICY - 2.04.521 Evaluation of Biomarkers for Alzheimer Disease BCBSA Ref. Policy: 2.04.14 Effective Date: Apr. 6, 2025 Last Revised: Jul. 1, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/5.01.588.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.588 Pharmacologic Prevention and Treatment of HIV/AIDS ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.596_2025-10-03.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.596 Pharmacologic Treatment of Osteoporosis Effective ... Medical Necessity criteria within this policy DOES NOT apply to Alaska fully- insured ...
https://www.premera.com/medicalpolicies/5.01.616_2025-10-03.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.616 Pharmacologic Treatment of Gout Effective Date: Oct. ... Medical Necessity criteria within this policy DOES NOT apply to Alaska fully- insured ...
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/5.01.642.pdf#search=policy
MEDICAL POLICY - 5.01.642 Gene Therapies for Rare Diseases BCBSA Ref. Policy: 5.01.49 Effective Date: Mar. 1, 2025 Last Revised: Jul. 1, 2025 Replaces: N/A RELATED MEDICAL ...