By Aravind Kumar · Published December 22, 2025 · Updated February 24, 2026
Major commercial payers have announced significant policy updates for 2025. Here's what your billing team needs to prepare for, and how to avoid preventable denials.
Every year, commercial payers update their policies, edits, and requirements. 2025 brings particularly impactful changes across prior authorization, modifier requirements, and medical necessity criteria. Practices that don't adapt will see increased denials.