May 27, 2026
Reimbursement policies, formerly known as clinical payment and coding policies, describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10 coding for claims submitted as covered services. These policies are not intended to address all coding or reimbursement related issues. We regularly add and modify reimbursement policy positions as part of our ongoing policy review process.
The following policies were updated:
- RP038 Outpatient Services Prior to an Inpatient Admission, effective May 22, 2026
- RP044 Global Obstetrical/OB Maternity Services Policy, effective May 22, 2026
CPT copyright 2025 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
Reimbursement policies are based on using healthcare professionals and industry standard guidelines. The coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.