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Policies and Guidelines > Coverage Policies

Coverage Policies

Coverage policies are developed to communicate Medica decisions about coverage and benefits for various medical services. Each coverage policy contains a description of the medical service, as well as the coverage determination, product application, coding considerations and requirements for prior authorization.

Both the coverage policy and utilization management policy sections should be checked to determine coverage for a particular service. 

Important note: Before using these policies, read the Coverage Policies Usage Notice.

Medical Technology Assessment Submission

Use this form to submit an inquiry regarding an existing Medica Coverage Policy or to submit information on a new technology. Please review this Provider & Vendor FAQ’s before submitting your inquiry.


Coverage Policies

Date: 2/5/2023 5:09:20 PM Version: 4.0.30319.42000 Machine Name: PWIVE-CDWEB01