Ambetter Clinical Coverage/Medical Policy Updates
Ambetter from Arkansas Health & Wellness updates a select number of clinical coverage policies each month, ensuring the reviewal of all policies on an annual basis.
Provider Notification
Ambetter from Arkansas Health and Wellness is amending or implementing new policies. Please see the table below for a list of these policies and their effective dates.
CP.BH.104 Applied Behavior Analysis (PDF)
CP.BH.105 Applied Behavioral Analysis Documentation Requirements (PDF)
CP.MP.82 NICU Apnea Bradycardia Guidelines (PDF)
CP.MP.102 Pancreas Transplantation (PDF)
CP.MP.162 Tandem Transplant (PDF)
CP.MP.163 Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (PDF)
CP.MP.40 Gastric Electrical Stimulation (PDF)
CP.MP.114 - Disc Decompression Procedures (PDF)
CP.MP.116 - Lysis of Epidural Lesions (PDF)
CP.MP.126 - Sacroiliac Joint Fusion (PDF)
CP.MP.188 - Pediatric Oral Function Therapy (PDF)
CP.MP.55 - Assisted Reproductive Technology (PDF)
CP.MP.57 - Lung Transplantation (PDF)
CP.MP.69 - Intensity-Modulated Radiotherapy (PDF)
CP.MP.132 - Heart-Lung Transplant (PDF)
CP.MP.176 - Outpatient Cardiac Rehabilitation (PDF)
CP.BH.200 - Transcranial Magnetic Stimulation for Treatment of Major Depression (PDF)
CP.MP.120 - Pediatric Liver Transplant (PDF)
CP.MP.129 - Fetal Surgery in Utero for Prenatally Diagnosed Malformations (PDF)
CP.MP.164 - Caudal or Interlaminar Epidural Steroid Injections (PDF)
CP.MP.171 - Facet Joint Interventions (PDF)
CP.MP.48 - Neuromuscular Electrical Stimulation (NMES) (PDF)
CP.BH.300 - Biofeedback for Behavioral Health Disorders (PDF)