Commonwealth Care Alliance

CCA Payment Policies

CCA’s payment policies are designed to assist providers when submitting claims to Commonwealth Care Alliance. These policies will be updated regularly to promote accurate coding, billing and policy clarification. CCA uses these payment policies as a guide to make determinations regarding healthcare coverage and payment.

Acupuncture Services
Claim Reconsideration
Durable Medical Equipment (DME)
Emergency Ambulance Services
Evaluation and Management Services (Modifier 25)
Fraud, Waste and Abuse
National Drug Code Requirement
NCCI Edit Initiative
NCCI Incidental Edit Policy
NCCI Rebundling Edit Policy
Observation Services
Outpatient Therapy Services
Serious Reportable Events (SRE)
Unlisted Procedure Code
Vision Services
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