Coverage Policy

Special Notice


(Specific to Discrete Procedures or Technologies)

The medical director of Arkansas Blue Cross and Blue Shield has established specific coverage policies addressing certain medical procedures or technologies.

The purpose of a Coverage Policy is to inform members and their physicians why certain medical procedures may or may not be covered under Arkansas Blue Cross and Blue Shield health plans. In addition to these specific Coverage Policies, all Arkansas Blue Cross and Blue Shield health plans or contracts also include more generally applicable coverage standards known or the Primary Coverage Criteria. The Primary Coverage Criteria apply to ALL benefits members may claim under their plan, no matter what types of health intervention may be involved or when or where members obtain the intervention. For more specifics on Primary Coverage Criteria, click on the Primary Coverage Criteria link below.

Search for a Policy

Please search using any of the options below:

What You Will See

When you select a policy, you will see its title, category and effective date at the top of the page. A description of the treatment and the actual policy, which explains what is covered, follow. At the bottom of the page, you will see related CPT codes and references.

Additional Information