Question 1

What insurance policy changes affect CPT 96158?

Accepted Answer

There are 4 tracked policy changes affecting CPT 96158, including updates from Maryland Medicaid, Oregon Health Plan, Alaska Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 96158?

Accepted Answer

Payers that have issued tracked updates for CPT 96158 include: Maryland Medicaid, Oregon Health Plan, Alaska Medicaid, Illinois Medicaid - HFS.

Question 3

How do I get notified when CPT 96158 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 96158. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 96158?

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.

96158 Insurance Policy Changes

PT 42-26: Updates to ABA Combination of Service Rules and Discontinuation of H2012

Behavioral Health Fee Schedule rate adjustments effective Jan. 1, 2026

Tribal FQHC FAQs Updated

Chapter U-200, Handbook for Local Education Agencies Updates to Appendix U-2, Procedure Codes Billable by Local Education Agencies