Question 1

What insurance policy changes affect CPT 99425?

Accepted Answer

There are 2 tracked policy changes affecting CPT 99425, including updates from Anthem BCBS, Molina Healthcare. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 99425?

Accepted Answer

Payers that have issued tracked updates for CPT 99425 include: Anthem BCBS, Molina Healthcare.

Question 3

How do I get notified when CPT 99425 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 99425. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 99425?

Accepted Answer

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

99425 Insurance Policy Changes

[California] Medi-Cal Managed Care fee-for-service transition for members with unsatisfactory immigration status

07-29-2026 DHCS policy guide for transition of the unsatisfactory immigration status population from managed care to Medi-Cal fee-for-service – Version 1.0 IE LA SAC SD