97016 Insurance Policy Changes

CPT 97016, in plain terms, covers Treatment using a specialized machine that applies alternating air pressure to help reduce swelling and improve circulation in your limbs. CPT 97016 is referenced in 4 tracked payer policy changes from Sentara Health Plans, CareSource, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 97016 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 97016 on AAPC