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You can usually find payer policies by searching online for the specific code and payer or logging into the payers provider portal, which will have a list of all the medical policies with reimbursement guidelines

J1438: Etanercept (Enbrel) for Rheumatoid Arthritis, Ankylosing Spondylitis

Section 425.655 is amended by revising paragraph (d)(2) to read as follows: Calculating the regional risk score growth cap adjustment factor

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The interested parties also stated that the direct supervision requirement can unfairly delay care for Medicare patients when, for example, a PTPP or OTPP is out sick, the practice does not have alternative coverage, and appointments for Medicare patients must be canceled