Select Health Policies

Policy Development

Select Health medical, dental, and coding/reimbursement policies represent our determination of whether services or devices are standard medical practice, experimental/investigational, cosmetic, or within coding standards.

Medical policies are based on Select Health determination of whether services or devices are standard medical practice, experimental/investigational, cosmetic, or within coding standards. These conclusions reflect our review of currently available clinical information including:

  • Research in peer-reviewed published medical literature
  • Regulatory status of the technology
  • Evidence-based guidelines of public health and health research agencies
  • Evidence-based guidelines and positions of leading national health professional organizations
  • Views of physicians practicing in relevant clinical areas
  • Other relevant factors

Laboratory utilization policies reflect a partnership between Select Health and Avalon Healthcare.  NOTE: Post-service automated policy adherence applies to outpatient laboratory services regardless of place of service. Learn more by accessing:

Coding & Reimbursement policies (both medical and dental) are based on a review of coding standards, including:

  • Centers for Medicare and Medicaid Services (CMS)
  • Current Procedural Terminology (CPT®)
  • Specialty societies (e.g., AAOS)
  • Other expert sources

NOTE: By accessing and/or downloading Select Health policies, you automatically agree to the Medical and Coding/Reimbursement Policy Manual Terms and Conditions.

Select Health Medical Policies (by category)

Access Select Health Medical Policies as a collection (in PDF form) for each category below (or you can access individual policies via a searchable database on the Select Health Provider Portal, which requires a secure login).

Allergy, Asthma, & Immunology General Medicine
Oral Maxillofacial
Anesthesia General Surgery Orthopedic
Behavioral Health Genetic Disease Pathology
Cardiovascular Genitourinary Pediatrics
Dermatology Hematology/Oncology Pharmacology
Durable Medical Equipment   Physical Medicine
Ear, Nose, & Throat Laboratory Utilization Policies: Part 1Part 2
Pulmonary
Endocrinology Neurology/Neurosurgery Radiology
Gastroenterology Obstetrics/Gynecology Women's Health
Ophthalmology

Navigating Medical Policy Collections

Find the exact policy you need within each collection.

Select Health Coding & Reimbursement Policies

Medical:

*See also, Chemotherapy, and Therapeutic, Prophylactic, and Diagnostic Injections and Infusions Policies

Dental:

Other Policy Resources