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Clinical Policy Updates
Ambetter of Tennessee continuously updates select clinical policies each month. This page reflects upcoming clinical policy changes. Please refer to this page for recent policy updates and reach out to your Provider Relations representative if you have any questions.
- Allogeneic Hematopoietic Progenitor Cell Therapy (CP.MP.249) (PDF)
- Bone-Anchored Hearing Aid (CP.MP.93) (PDF)
- Fecal Incontinence Treatments (CP.MP.137) (PDF)
- Physical, Occupational, and Speech Therapy Services (CP.MP.49) (PDF)
- Reduction Mammoplasty and Gynecomastia Surgery (CP.MP.51) (PDF)
- Sacroiliac Joint Interventions for Pain Management (CP.MP.166) (PDF)
- Selective Nerve Root Blocks and Transforaminal Epidural Steroid Injections (CP.MP.165) (PDF)
- Total Artificial Heart (CP.MP.127) (PDF)
- Applied Behavior Analysis (CP.BH.104) (PDF)
- Durable Medical Equipment and Orthotics and Prosthetics Guidelines (CP.MP.107) (PDF)
- IV Moderate Sedation, IV Deep Sedation, and General Anesthesia for Dental Procedures (CP.MP.61) (PDF)
- Orthognathic Surgery (CP.MP.202) (PDF)
- Radiation Therapy for Skin Cancer (CP.MP.251) (PDF)
- Electric Tumor Treating Fields (CP.MP.145) (PDF)
- Facility Based Sleep Studies for Obstructive Sleep Apnea (CP.MP.248) (PDF)
- Pediatric Oral Function Therapy (CP.MP.188) (PDF)
- Skin and Soft Tissue Substitutes for Chronic Wounds (CP.MP.185) (PDF)
- Transplant Service Documentation Requirements (CP.MP.247) (PDF)