SummaCare follows all Centers for Medicare and Medicaid Services (CMS) and applicable state rules and regulations pertaining to all Medicare Advantage Plans. SummaCare Clinical Policies are intended to be used in connection with the independent professional medical judgment of a qualified health care provider and do not constitute the practice of medicine or medical advice.
2025 Oncology Biomarkers Policy
Aerolase
Alzheimer's Disease Biomarkers Policy
Aquablation Robotic Therapy Policy
Augmentation Cystoplasty
Autologous Platelet-Derived Growth Factors
Benign Skin Lesion Removal
Bone and Tendon Graft Substitutes
Bone Marrow Transplant Donor
Bronchial Valve Policy
Cardiac Event Monitors
Cardiomems
Clinical Trials
Continuous Glucose Monitoring System and External Insulin Infusion Pump Policy
Continuous Positive airway pressure
Corneal Collagen Cross-linking
Deep brain stimulation
DME Noninvasive Positive Pressure Vent
Elastography Policy
ENT and Respiratory Procedures Policy
External Trigeminal Nerve Stimulation for ADHD Disorder
Fecal Analysis Panels for Intestinal Disorders Policy
Gender Reassignment Surgery Policy
Gene Therapy
General Anesthesia for Dental Procedures
GI and GU Procedures Policy
Glaucoma Surgeries Policy
Gynecological Procedures Policy
Heart Transplant Rejection
High-flow Humidified Nasal Cannula Oxygen Therapy for Home Use Policy
Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea
Implantable Sinus Stents
LINX
LVAD
Lymphedema Treatment Policy
Melanoma
Minimally Invasive Hemorrhoid Procedure
Minimally Invasive Lumbar Decompression (MILD)
Motor Cortex Stimulation
NASHnex Policy
Nerve Grafting Policy
Neuropsychological Testing
Ophthalmology Procedures Policy
Orthognathic surgery
Orthopedic Procedures Policy
Per and polyfluoroalkyl substances (PFAS) testing Policy
Percutaneous Left Atrial Appendage Closure (LAAC)
Prenatal Genetic Testing-Cell Free Genetic Testing
Proprietary Laboratory Analyses Policy
Prostate Rectal Spacer (SpaceOAR)
Pulsed Dye Laser Treatment
Radiofrequency Ablation for Peripheral Nerve Pain Policy
Radiofrequency Ablation for Spine Pain Policy
Salimetrics Salivary Melatonin Profile Policy
Screening for Prediction and Prevention Pre-eclampsia
Site of Care Policy
Streptococcus Pneumoniae Antibody Testing Policy
Surgical Interruption of Pelvic Nerve Pathways
Technology Policy for 2025
Tissue-Engineered Skin Substitutes
Transcranial Magnetic Stimulation
Transcatheter Valves
Unlisted CPT and HCPCS code Policy
Urinary Incontinence
VanSeal (Cyanoacrylate) Policy
Vocal Cord Paralysis and Insufficiency Treatments Policy
Wearable and Non-Wearable Cardioverter Defibrillator