{"id":8899,"date":"2026-05-29T19:04:22","date_gmt":"2026-05-29T19:04:22","guid":{"rendered":"https:\/\/hnetalk.com\/provider\/?p=8899"},"modified":"2026-05-29T19:04:22","modified_gmt":"2026-05-29T19:04:22","slug":"medical-policy-updates-june-2026","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/medical-policy-updates-june-2026\/","title":{"rendered":"Medical Policy Updates (June 2026)"},"content":{"rendered":"

Please read the following update related to various Health New England programs and changes that may have an impact on your patients and\/or your practice. To find policies noted below, please visit healthnewengland.org\/Providers\/Resources<\/a>.<\/p>\n

If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension 5000. A representative is available Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m.<\/p>\n

 <\/p>\n\n\n\n\n\n\n\n\n\n\n
Medical Policy Revisions<\/strong><\/td>\nEffective Date<\/strong><\/td>\nNotes<\/strong><\/td>\n<\/tr>\n
Ambulatory Electrocardiograph Monitoring<\/td>\nAugust 2026<\/td>\n\n
    \n
  • All Lines of Business<\/li>\n
  • Minor changes to self-monitoring section<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Neurostimulators<\/td>\nAugust 2026<\/td>\n\n
    \n
  • All Lines of Business<\/li>\n
  • InterQual Medicare Procedure Criteria added for:\n
      \n
    • Spinal stimulation<\/li>\n
    • Deep brain and cortical stimulation<\/li>\n
    • Sacral nerve stimulation<\/li>\n
    • Percutaneous tibial nerve stimulation<\/li>\n
    • Vagus nerve stimulation<\/li>\n<\/ul>\n<\/li>\n
    • Epicranial focal cortex stimulation added to the policy<\/li>\n
    • CPT 64580 added to the coding tables<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Percutaneous Neuroablation<\/p>\n

\u00a0<\/strong><\/td>\n

August 2026<\/td>\n\n
    \n
  • All Lines of Business<\/li>\n
  • HNE has adopted InterQual Medicare: Procedures, Facet Joint Interventions for Pain Management NGS for Facet Joint Neuroablation<\/li>\n
  • Other minor criteria changes<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Peripherally Implanted Nerve Stimulation (PNS), Peripheral Subcutaneous Field Stimulation (PSFS), Percutaneous Electrical Nerve Field Stimulation (PENFS)<\/td>\nAugust 2026<\/td>\n\n
    \n
  • All Lines of Business<\/li>\n
  • InterQual Medicare: Procedure criteria added for Medicare line of business<\/li>\n<\/ul>\n

     <\/td>\n<\/tr>\n

Transcranial Magnetic Stimulation (TMS)<\/td>\nAugust 2026<\/td>\n\n
    \n
  • All Lines of Business<\/li>\n
  • Criteria updated with: Evidence of resistance to or inability to tolerate psychopharmacological agents requiring two or more trials of psychopharmacologic agents from at least two different classes of antidepressant medications during current depression episode<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
New Medical Policy<\/strong><\/td>\nEffective Date<\/strong><\/td>\nNotes<\/strong><\/td>\n<\/tr>\n
Superficial Radiation Therapy for the Treatment of Nonmelanoma Skin Cancers<\/td>\nAugust 2026<\/td>\n\n
    \n
  • All Lines of Business<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    Please read the following update related to various Health New England programs and changes that may have an impact on your patients and\/or your practice. To find policies noted below, please visit healthnewengland.org\/Providers\/Resources. If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension […]<\/p>\n","protected":false},"author":11,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[],"class_list":["post-8899","post","type-post","status-publish","format-standard","hentry","category-provider-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-2jx","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8899","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=8899"}],"version-history":[{"count":5,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8899\/revisions"}],"predecessor-version":[{"id":8910,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8899\/revisions\/8910"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=8899"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=8899"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=8899"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}