What insurance policy changes were tracked in 2026?

In 2026 we tracked 33,710 policy changes across major U.S. health insurance payers. Changes include prior authorization rule updates, billing-code coverage modifications, fee schedule revisions, and plan-type policy changes.

How do I find 2026 policy changes for my specialty or state?

Use the related-hub links below the list to filter by provider, state, or specialty. You can also browse the full /changes feed and use pagination to reach the 2026 date range.

Insurance Policy Changes in 2026: Full Archive

High impact

Positive Pressure Ventilation (CPB 0452, reviewed 2026-07-01)

Aetna·Effective Jul 1, 2026

Aetna has updated its Positive Pressure Ventilation policy (CPB 0452, effective July 1, 2026) establishing comprehensive medical necessity criteria for noninvasive positive pressure ventilation (NPPV) devices including bilevel PAP with and without backup rate features. The policy specifies detailed diagnostic testing requirements, clinical thresholds (e.g., PaCO2 levels, oxygen saturation parameters), and conditions under which each device type is covered for restrictive thoracic disorders, COPD, sleep apnea, hypoventilation syndrome, and other respiratory conditions. Billing teams must implement prior authorization workflows requiring documented arterial blood gas values, sleep studies, spirometry results, and compliance monitoring to support claims.

Earn Continuing Education Credit: Webinar on Perinatal Mental Health

Reimbursement available for Medicaid mental health screening assessments including telehealth

We've simplified our process for submitting Level 1 and 2 claim disputes

Reminder: Medicare Bridge PA requests aren't processed through Priority Health

We're encouraging select members to discuss biosimilars with their providers

Need access to past remittance advices? Take action today on the new Provider Portal

Five actions to take before the new Provider Portal launches on September 1

Notice of Admission requirement postponed

[Indiana] Save the Date: August 2026 Behavioral Health Live Orientation

[Indiana] Save the Date: August 2026 Live Provider Orientation

Prolotherapy and Sclerotherapy (CPB 0207, reviewed 2026-03-27)

Crit-Line In-Line Monitor (CPB 0373, reviewed 2026-05-26)

Critical Flicker Fusion (CPB 0860, reviewed 2025-12-24)

Procalcitonin (PCT) (CPB 0771, reviewed 2025-11-13)

Cranial Remodeling (CPB 0379, reviewed 2026-05-26)

Prescription Digital Therapeutics (CPB 0999, reviewed 2026-06-19)

Pressure Reducing Support Surfaces (CPB 0430, reviewed 2026-07-10)

Prenatal Care Provided by Primary Care Physicians (CPB 0047, reviewed 2026-03-10)

Preconceptional Sex Selection Techniques (CPB 0323, reviewed 2026-05-20)

Prademagene Zamikeracel (Zevaskyn) (CPB 1084, reviewed 2026-05-27)

Pozelimab-bbfg (Veopoz) (CPB 1043, reviewed 2025-12-09)

Positron Emission Tomography (PET) (CPB 0071, reviewed 2026-07-28)

Positive Pressure Ventilation (CPB 0452, reviewed 2026-07-01)

Pool Therapy, Aquatic Therapy or Hydrotherapy (CPB 0174, reviewed 2026-04-21)

Polymerase Chain Reaction Testing: Selected Indications (CPB 0650, reviewed 2026-01-27)

Polio Vaccine (CPB 0402, reviewed 2026-07-07)

Pneumococcal Vaccines (CPB 0037, reviewed 2026-03-02)

Polatuzumab Vedotin-piiq (Polivy) (CPB 0955, reviewed 2025-03-13)

Plerixafor (CPB 0779, reviewed 2026-02-13)

Plozasiran (Redemplo) (CPB 1096, reviewed 12-2026-03)

Eptinezumab-jjmr (Vyepti) (CPB 0970, reviewed 2025-12-09)

Plasminogen, Human-tvmh (Ryplazim) (CPB 0976, reviewed 2026-02-17)

Plasmapheresis/Plasma Exchange/Therapeutic Apheresis (CPB 0285, reviewed 2026-04-16)

Physical Therapy (CPB 0325, reviewed 2026-06-02)

Pillows and Cushions (CPB 0456, reviewed 2026-07-09)

Phototherapy for Acne (CPB 0656, reviewed 2025-10-03)

Erythropoiesis Stimulating Agents (CPB 0195, reviewed 2026-01-20)

Etanercept (CPB 0315, reviewed 2026-07-08)

Esketamine (Spravato) (CPB 0950, reviewed 2026-02-25)

Evinacumab-dgnb (Evkeeza) (CPB 0989, reviewed 2026-04-10)

Exagamglogene Autotemcel (Casgevy) (CPB 1052, reviewed 2025-12-31)

Erectile Dysfunction and Peyronie's Disease (CPB 0007, reviewed 2026-07-29)

Extended-Release Buprenorphine Injectables (CPB 0910, reviewed 2025-12-30)

Pharmacogenetic and Pharmacodynamic Testing (CPB 0715, reviewed 2025-12-03)

Eladocagene Exuparvovec-tneq (Kebilidi) (CPB 1073, reviewed 2026-03-27)

Electric Tumor Treatment Fields (CPB 0827, reviewed 2026-02-18)

Endovascular Arterial and Venous Stent Procedures (CPB 0785, reviewed 2026-06-05)

Peripheral Electrical Nerve Stimulation for Pain (CPB 0011, reviewed 2026-06-03)

Elivaldogene Autotemcel (Skysona) (CPB 1017, reviewed 2026-04-08)

Percutaneous Transluminal Septal Myocardial Ablation (PTSMA) (CPB 0558, reviewed 2026-02-19)