Medical Policies

Johns Hopkins Health Plans medical policies are developed to assist in administering plan benefits and do not constitute medical advice. Please read our CMS01.00 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 the service or supply.


B

CMS02.13 Bronchial Thermoplasty in the Treatment of Asthma

C

CMS11.01 Clinical Practice Guidelines Policy
CMS03.01 Clinical Trials
CMS05.02 Computed Tomography and Coronary Calcium Scoring
CMS01.09 Continuity of Care and Access to Non-Participating Providers
CMS03.12 Cosmetic and Reconstructive Services

D

CMS19.07 Dynamic Splinting for the Treatment of Joint Stiffness and Contracture

E

CMS20.05 Expanded Access and Compassionate Use

F

CMS15.04 Foot Orthotics

G

CMS20.03 Gastroesophageal Reflux Disease (GERD) Devices
CMS07.05 Gender Affirming Treatment & Procedures
CMS24.08 Gender Affirming Treatment & Procedures - EHP
CMS07.03 Genetic Testing 
CMS24.16 Genicular Nerve Treatments for Chronic Knee Pain

H

CMS24.14 Habilitative Therapy
CMS24.07 High Risk Obstetrical Home Care (OPTUM)
CMS03.00 Hospice and Palliative Services

I

CMS24.11 Incontinence Supplies
CMS23.07 Infertility Evaluation and Treatment
CMS24.12
Investigational & Experimental Services

J

K

L

M

CMS22.01 Minimally Invasive Treatments of Varicosities

N

CMS21.01 Neuromodulation for Overactive Bladder, Urinary Retention & Fecal Incontinence
CMS24.18 Neuropsychological Testing
CMS24.06 Non-Emergency Ambulance Transportation
CMS14.02 Nutritional Assessment and Management
CMS14.04 Nutritional Treatment - Medically Necessary Food

O

P

CMS03.08 Panniculectomy
CMS16.15 Pediatric Feeding Programs
CMS04.03 Pharmacogenomics
CMS16.19 Prenatal Obstetrical Ultrasound
CMS11.02 Preventive Health Guidelines
CMS24.05 Private Duty Nursing (PPMCO)
CMS16.18 Prosthetic Devices
CMS16.12 Pulsed Electrical Stimulation Devices

Q

R

S

CMS23.05 Site of Service - Outpatient Surgical Procedures
CMS23.08 Site of Service - Sleep Studies
CMS19.05 Solid Organ Transplant
CMS19.08 Speech Devices

T

CMS02.09 Testing for Hereditary Breast and Ovarian Cancer Syndromes
CMS20.04 Thermography
CMS16.02 Treatment for Skin Conditions
CMS02.16 Treatment of the Cornea and Refractive Lenses

U

V

CMS22.06 Vagus Nerve Stimulation for Depression

W

X

Y

Z