What insurance policy changes affect CPT 90913?

There are 9 tracked policy changes affecting CPT 90913, including updates from Sentara Health Plans, Capital Blue Cross, Blue Cross Blue Shield of Rhode Island. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 90913?

Payers that have issued tracked updates for CPT 90913 include: Sentara Health Plans, Capital Blue Cross, Blue Cross Blue Shield of Rhode Island, Health Net, Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 90913 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 90913. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 90913?

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.

90913 — Biofeedback training session for an additional fifteen-minute increment beyond the initial session.: Insurance Policy Changes

90913 Insurance Policy Changes

CPT 90913, in plain terms, covers Biofeedback training session for an additional fifteen-minute increment beyond the initial session. CPT 90913 is referenced in 9 tracked payer policy changes from Sentara Health Plans, Capital Blue Cross, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 90913 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

Fecal Incontinence (CPB 0611, reviewed 2026-02-25)

Aetna·Effective Feb 25, 2026

Aetna updated its fecal incontinence policy (CPB 0611) effective February 25, 2026, establishing clear medical necessity criteria for diagnostic tests, conservative treatments, and invasive procedures. The policy requires a 3-month trial of at least 2 conservative treatments before approving surgical interventions (sphincter repair, colostomy) or advanced devices (Acticon Neosphincter, sacral nerve stimulation). Multiple experimental procedures are listed as non-covered, including anal slings, graciloplasty, injectable bulking agents, magnetic sphincter augmentation, and regenerative medicine approaches.

90913 Insurance Policy Changes

Authorization Updates - Effective October 1, 2026

AB2026-07-005 Medical policies

Medical policy updates

20-709 Medical Policies - 2nd Quarter 2020

20-711 Medical Policies - 2nd Quarter 2020

20-712 Medical Policies - 2nd Quarter 2020

Biofeedback (CPB 0132, reviewed 2026-07-16)

Fecal Incontinence (CPB 0611, reviewed 2026-02-25)

Biofeedback