20979 Insurance Policy Changes

CPT 20979, in plain terms, covers Using ultrasound waves to stimulate and promote healing in a broken or damaged bone. CPT 20979 is referenced in 5 tracked payer policy changes from Excellus BlueCross BlueShield, Sentara Health Plans, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 20979 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 20979 on AAPC

Excellus BlueCross BlueShield · Effective Apr 16, 2026Medium impact
Bone Growth Stimulators 1.01.53
Excellus BlueCross BlueShield medical policy 1.01.53 has a current effective date of April 16, 2026. Noninvasive electrical bone growth stimulation is medically appropriate for infantile non-union, failed ankle or knee joint fusion, and non-union secondary to trauma of the appendicular skeleton when the listed criteria are met, and for spinal fusion in individuals at high risk for fusion failure. For appendicular non-union, three months or more must have elapsed since the injury or initial treatment, the fracture gap must be 1 centimeter or less, and at least two sets of serial radiographs obtained a minimum of 90 days apart must show no clinically significant progression of healing. Ultrasound accelerated fracture healing systems are medically appropriate for non-union fractures when at least three months have elapsed and two sets of radiographs at least 90 days apart show no clinically significant evidence of healing. Electrical stimulation for fresh fractures, stress fractures, delayed unions and fresh bunionectomies is investigational. The 2026 annual review clarified the timing requirement for radiographs and left policy intent unchanged.
Sentara Health Plans · Effective Oct 1, 2025Medium impact
Authorization Updates - Effective October 1, 2025
Sentara Health Plans' authorization updates effective October 1, 2025 archived several policies, including Deep Brain Stimulation (Surgical 74), Electric Bone Growth Stimulation (DME 09), Near-infrared Spectroscopy (Medical 330) and Home Spirometry (DME 23), with the stimulation policies moved into the new Electrical Stimulation policy (Medical 349). On October 1, 2025, prior authorization became required (Y) for 44 listed procedure codes and for codes including 0420U, 0421U, 0435U, 0212U, 0213U, 81500, 81503, 81528, 88230 and 89420, with some codes directed to OncoHealth or Avalon, and 97161 and 97162 require authorization with benefit limits. Earlier updates effective July 1 and August 1, 2025 removed authorization for codes including 98975, 98976, 98977, 98978, 98980 and 98981, and required authorization for Medicaid codes 0253U, 0254U and 0255U.
Aetna · Identified Aug 14, 2026Medium impact
Bone Growth Stimulators (CPB 0343, reviewed 2026-05-26)
Ultrasonic bone growth stimulators are considered medically necessary as durable medical equipment for fresh closed or grade I open tibial shaft fractures treated with closed reduction and cast immobilization, for fresh scaphoid, fifth metatarsal (Jones) or distal radius (Colles) fractures treated with closed reduction and cast immobilization, and for non-unions, failed arthrodesis or congenital pseudarthrosis of the appendicular skeleton with no X-ray evidence of progression of healing for 3 or more months despite appropriate fracture care. Electrical bone growth stimulators are considered medically necessary for delayed unions or failed arthrodesis at high-risk sites such as open or segmental tibial fractures, carpal navicular, fifth metatarsal, distal radius and sesamoid fractures, and for non-unions where the bone is noninfected, stable on both ends by cast or fixation, and separated by less than 1 centimeter, and for spinal fusion with a multiple level fusion of 3 or more vertebrae, grade II or worse spondylolisthesis, or one or more failed fusions. Ultrasonic stimulators are considered experimental, investigational, or unproven for fractures, failed fusions or non-unions of the skull and vertebrae, stress fractures, and fractures with post-reduction displacement of more than 50%, while electrical stimulators are considered experimental, investigational, or unproven for indications such as Charcot arthropathy, avascular necrosis of the hip, comminuted toe fractures and loosened hip or knee prostheses, and semi-invasive stimulators are considered unproven for all indications.
Aetna · Identified Aug 14, 2026Medium impact
Distraction Osteosynthesis (CPB 0220, reviewed 2026-04-09)
Aetna considers the Ilizarov method for distraction osteosynthesis medically necessary for members with an angular or rotational deformity of a long bone, a bone defect, or a limb length discrepancy who also meet one of the listed selection criteria, such as a leg length discrepancy of more than 4 cm, an arm length discrepancy of more than 5 cm, or a long bone fracture not healed in 6 or more months after electrical stimulation and bone grafting have failed. The PRECICE intramedullary limb lengthening system is considered medically necessary for lengthening the tibia and femur in persons with a leg length discrepancy of more than 4 cm. Ilizarov use for other indications, the intramedullary skeletal kinetic distractor, pulsed ultrasound as an adjuvant therapy, and Phenix nails are considered experimental, investigational or unproven, and Ilizarov use to correct short stature is considered cosmetic.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Low Intensity Pulsed Ultrasound Fracture Healing Device
Low-intensity pulsed ultrasound may be considered medically necessary as an adjunct to closed reduction and cast immobilization for fresh, closed fractures in skeletally mature individuals who are at high risk for delayed fracture healing or nonunion. It may also be considered medically necessary for delayed union and for nonunion, including nonunion of previously surgically treated fractures, excluding the skull and vertebra. Other applications, including congenital pseudarthroses, open fractures, fresh surgically treated closed fractures, stress fractures, and arthrodesis or failed arthrodesis, are investigational. A 08/28/2026 policy update changed the device description and removed ICD-9 procedure and diagnosis codes from the code reference, and the policy statements did not change.

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REFERENCE DATA

Payers with rules4

Payers requiring prior auth4

Anthem BCBS · Effective November 1, 2026
Prior authorization required
Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)
BCBS Michigan · Effective October 13, 2026
Prior authorization required in some cases
BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)
BCBS Arizona · Effective October 1, 2026
Prior authorization required
AZ Blue Medicare Advantage Prior Authorization Requirements Code List (Updated 10/01/2026)

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for 20979?

Anthem BCBS lists 20979 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does BCBS Arizona require prior authorization for 20979?

BCBS Arizona lists 20979 on AZ Blue Medicare Advantage Prior Authorization Requirements Code List (Updated 10/01/2026) for medicare advantage plans (list dated October 1, 2026). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 20979?

BCBS Michigan lists 20979 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans, with conditions (list dated October 13, 2026). Verify with the payer before scheduling.

Does Elevance Health require prior authorization for 20979?

Elevance Health lists 20979 on List of items and services that require prior authorization (Medicaid GA) for medicaid managed plans (list dated February 11, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 20979?

There are 5 tracked policy changes affecting CPT 20979, including updates from Excellus BlueCross BlueShield, Sentara Health Plans, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 20979?

Payers that have issued tracked updates for CPT 20979 include: Excellus BlueCross BlueShield, Sentara Health Plans, Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 20979 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 20979. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 20979?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

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Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 20979 in one place.

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All billing codes J3590 C9399 J3490 99215 99213 99202

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Bone Growth Stimulators 1.01.53

Authorization Updates - Effective October 1, 2025

Bone Growth Stimulators (CPB 0343, reviewed 2026-05-26)

Distraction Osteosynthesis (CPB 0220, reviewed 2026-04-09)

Low Intensity Pulsed Ultrasound Fracture Healing Device

Prior authorization required

Prior authorization required in some cases