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Policies

Johns Hopkins HealthCare Policies are developed to assist in administering plan benefits and does not constitute medical advice. Please read our Medical Policy Introduction.

Please remember: Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply.

Read our medical policies disclaimer.

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A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

 

A

Acthar Gel
Acupuncture
Airway Clearance Devices
Apnea Monitor for Infants
Applied Behavioral Analysis
Autologous Chrondrocyte Implantation

B

Bariatric Surgery
Bevacizumab (Avastin)
Biofeedback
Biologic Response Modifiers Prior Authorization
Blepharoplasty
Bone Marrow and Stem Cell Transplantation
Botulinum Toxins A and B
BRCA 1 and BRCA 2
Breast Ductal Lavage
Breast Reduction Surgery
Bronchial Thermoplasty
Bunionectomy

C

Capsule Endoscopy
Cardiac Rehabilitation
Cardiac Tomography Angiography
Clinical Trials
Colorectal Cancer Screening
Continuous Glucose Monitoring
Continuous Subcutaneous Insulin Infusion Pumps

D

Dynamic Splinting

E

Electrical Stimulation for Treatment of Bell's Palsy
Electroencephalographic Video Monitoring
Electronic Evaluation and Management Services
Emergency Department Review Process
Enuresis Alarms in Children
Esophageal pH Monitoring
Evaluation and Treatment of Pediatric Feeding Disorders
Exercise Program for Peripheral Artery Disease
Exhaled Nitric Oxide Measurement
External Counterpulsation
Extracorpeal Shock Wave Therapy

F

Facet Blocks
Fecal DNA Pre-Gen Plus
Foot Orthotics
Fundus Photography for Diabetics

G

Gastric Electrical Stimulation for Gastroparesis
Gastroesophageal Reflux Disease (GERD) Devices
Genetic Testing

H

Hepatitis C Interferons
High-Frequency Pulsed Electromagnetic Stimulation
Hyperbaric Oxygen Therapy

I

Implantable Infusion Pumps
Implanted Devices for Hearing Loss
Interferential Therapy
Intradiscal Electrothermal Therapy
Invitro Fertilization Attempts

J

K

L

Lung Reduction Surgery

M

Magnetic Resonance Imaging (MRI) of Breast
Magnetoencephalography Magnetic Source Imaging
Mastectomy for Gynecomastia in Males
Multiple Myeloma

N

Nerve Conduction Velocity Studies and EMG 
Non-Payment of Preventable Adverse Events
Nutritional Counseling

O

Observation Policy
Oxygen and Oxygen Supplies

P

Peak Flow Meters
Percutaneous Techniques for Disc Decompression
Penile Prosthesis
Phototherapy for Seasonal Affective Disorder
Phototherapy in the Treatment of Psoriasis
Physician Assistant Reimbursement Policy
Positron Emission Tomography
Pre-Embryo and Embryo Cyropreservation
Primary Care Quality & Efficiency Standards for HealthCare Quality Improvement
Protease Inhibitors for Hepatitis C
Prothrombin Time Self Monitoring Devices
Pulmonary Rehabilitation
Pulse Dye Laser Treatment
Pulse Electrical Stimulation for the Knee
Pulse Oximetry

Q

R

Radiofrequency Ablation for Chronic Back Pain
Reconstructive Surgery After Weight Loss
Remicade Prior Authorization
Rituxan

S

Sacral Nerve Stimulation for Urge Urinary Incontinence
Serum Antibodies Assays for the Diagnosis of IBD
Skin Tag Removal
Solid Organ Transplant
SpeechEasy Device
Spinal Cord Stimulators
Surgical Decompression for Diabetic Neuropathy
Supprelin

T

Temporomandibular Disorders
Thermography
Transplant Policy
Treatment of Acne & Actinic Keratosis
Treatment of Varicosities
Transcranial Magnetic Stimulation

U

V

Vagus Nerve Stimulation for Depression
Ventral Hernia Repair of Diastasis Recti
Ventricular Assist Devices
Vestibular Rehabiliation and Canalith Repositioning

W

Wheelchairs and Power Operated Vehicles (POV)

X

Y

Z

Zytiga and Xtandi Prior Authorization

Please continue to check back. Policies are being added often.

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