For New Jersey health care professionals: According to NJ SB 2824 (C.17B:30-51), Clinical Policy Bulletin changes are not effective until 30 days after the Last Review Date.
Using Clinical Policy Bulletins to determine medical coverage
Medical Clinical Policy Bulletins (CPBs) detail the services and procedures we consider medically necessary, cosmetic, or experimental and unproven. They help us decide what we will and will not cover. CPBs are based on:
- Peer-reviewed, published medical journals
- A review of available studies on a particular topic
- Evidence-based consensus statements
- Expert opinions of health care professionals
- Guidelines from nationally recognized health care organizations
Attention: Pennsylvania Medicaid providers
We have different CPBs for Pennsylvania Medicaid. They are not available through search. Instead, use the link below.
Search our Medical Clinical Policy Bulletins
Enter your keyword or 4-digit CPB number (for example, enter 0059 to find CPB 59) to find related Medical Clinical Policy Bulletins.