Question 1

What insurance policy changes affect CPT 78104?

Accepted Answer

There are 1 tracked policy change affecting CPT 78104, including updates from Highmark. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 78104?

Accepted Answer

Payers that have issued tracked updates for CPT 78104 include: Highmark.

Question 3

How do I get notified when CPT 78104 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 78104. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 78104?

Accepted Answer

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.

78104 Insurance Policy Changes

Prior Authorization Updates: Two Additions and 90+ Removals