Quick Overview
- 1 new coding/reimbursement policy
- 5 revised medical policies
- 1 archived policy
- Coding news and updates
Policy Bulletin
February 2026 Policy Updates
New Policies
Category
Policy Title (Number)
Date
Summary of Change
Breast Cancer Screening Requirements When Additional Follow-Up is Needed
Policy #CR-102
01/01/2026
Created and published this new coding/reimbursement policy.
Revised Policies
*Changes apply ONLY to Commercial plan policy UNLESS summary text appears in bold.
Category
Policy Title (Number)
Date
Summary of Change
Applied Behavior Analysis (ABA)
Policy #630
01/01/2026
• Removed language regarding exceptions for members on FEHB plans. • Modified the titles of headers in both criteria section A (“Medical Necessity to qualify for ABA and State Requirements”) and criteria section B (“Essential Elements and Medical Necessity to initiate ABA”). • Modified and reorganized requirements outlined in both these sections.
Genetic Testing: Chromosomal Microarray Analysis (CMA)
Policy #297
01/05/2026
• Removed previous criterion #B-1: “Common aneuploidy (trisomy 13, 18, 21, or sex chromosome) is not a suspected diagnosis … .” • Added new criteria section #D: “Select Health covers use of chromosomal microarray analysis (CMA) for HNF1B-MODY in individuals with renal cysts and diabetes.”
Lipedema Treatment
Policy #683
01/07/2026
• Changed requirements for conservative management from three or more months to six or more months in both criterion #I-B2 and criterion #II-Bi. • Added CPT codes 15832, 15833, and 15834 as covered when criteria are met.
Speech Therapy Guidelines
Policy #178
01/14/2026
• Reformatted criteria so requirements in sections 1 and 2 (Written Plan of Care and Covered Conditions) are listed first. • Modified requirements in criterion #2f: “Dysphagia and pediatric feeding disorders … .”
Viscosupplementation
Policy #188
12/30/2025
• Removed specialist requirement. • Updated list of conservative therapies. • Removed requirement concerning total knee replacement. • Removed criterion concerning chart notes being required. • Clarified requirements in criterion #4d to read: “Intra-articular steroid injection (at least 1-month trial within the past 6 months; limit of 2 injections) … .”
Archived Policies
Category
Policy Title (Number)
Date
Summary of Change
Gastroenterology
Pancragen Molecular Diagnostic Test for Evaluation of Pancreatic Cysts
Policy #603
01/12/2026
Archived policy; this policy is no longer needed as this test is no longer available.
Coding Updates
Psychotherapy Codes 90832-90838
Select Health has realigned our policy for time-based individual psychotherapy codes 90832–90838 to follow guidelines from the American Medical Association (AMA). Effective January 1, 2026, only one unit per date of service will be allowed for these codes, in accordance with the official AMA descriptions and section guidelines.
Realigned Editing System Coming in 2026
Select Health will be transitioning to a new editing system that will better align our editing processes with standard coding practices and Select Health policies, ultimately improving edit consistency and accuracy. The new platform is expected to launch in the first quarter of 2026.
Diagnosis Mapping Reminder
Proper mapping of diagnosis codes to the appropriate procedures is critical for accurate coding and reduced claim denial risk. Select Health encourages providers to routinely review coding practices within your teams to help ensure timely and compliant claims processing.
Questions? Contact your Provider Relations representative.