Question 1

What insurance policy changes affect CPT 96131?

Accepted Answer

There are 6 tracked policy changes affecting CPT 96131, including updates from Harvard Pilgrim Health Care, Nevada Medicaid, Colorado Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 96131?

Accepted Answer

Payers that have issued tracked updates for CPT 96131 include: Harvard Pilgrim Health Care, Nevada Medicaid, Colorado Medicaid, Humana.

Question 3

How do I get notified when CPT 96131 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 96131. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 96131?

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.

96131 Insurance Policy Changes

Point32Health Payment Policy updates

Prior Authorization Updated in the Medicaid Management Information System for Neuropsychological, Psychological, and Developmental Testing Codes and Billing Guides Updated

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2600535 - 03/2026)

Update: Telehealth flexibilities for Medicare members

Billing for psychological and neuropsychological testing

Psychological and Neuropsychological Testing - Medicare Advantage (New)