What insurance policy changes affect CPT 64595?

There are 11 tracked policy changes affecting CPT 64595, including updates from Anthem BCBS, Health Net, Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 64595?

Payers that have issued tracked updates for CPT 64595 include: Anthem BCBS, Health Net, Humana, Blue Cross Blue Shield of Rhode Island, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 64595 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 64595. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 64595?

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.

64595 — Removing or revising a surgically placed tube that delivers medication directly to your stomach or intestines.: Insurance Policy Changes

64595 Insurance Policy Changes

CPT 64595, in plain terms, covers Removing or revising a surgically placed tube that delivers medication directly to your stomach or intestines. CPT 64595 is referenced in 11 tracked payer policy changes from Anthem BCBS, Health Net, and 3 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 64595 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

[New York] March 2026 Provider Newsletter

Anthem BCBS·Effective Apr 1, 2026

This is a March 2026 provider newsletter from Anthem summarizing multiple administrative, educational, and policy updates across New York commercial, Medicare Advantage, and Medicaid plans. Key billing-related changes include: (1) Prior authorization requirement changes effective April 1, 2026 for Medicaid and June 1, 2026 for Commercial (codes 64595, J3402, J3403); (2) Modifier 26 (professional services) billing changes on UB-04 for outpatient facilities effective April 1, 2026; (3) Bundled services/supplies reimbursement policy updates effective June 1, 2026; (4) MCG Care Guidelines 30th edition updates effective June 1, 2026; and (5) New MLTC fax numbers and dispute submission process changes effective March 1, 2026.

64595 Insurance Policy Changes

[New York] March 2026 Provider Newsletter

21-790 Medical Policies - 3rd Quarter 2021

21-792 Medical Policies - 3rd Quarter 2021

[California] Prior authorization requirement changes

Nerve Stimulation for Urinary Incontinence - Medicare Advantage (Revised)

[New York] Prior authorization requirement changes

[Virginia] March 2026 Provider Newsletter

Nerve Stimulation for Fecal Incontinence - Medicare Advantage (Revised)

Medical policy updates

Gastric Pacing and Gastric Electrical Stimulation - Medicare Advantage (Revised)

Gastric Electrical Stimulation