Question 1

What insurance policy changes affect CPT 97112?

Accepted Answer

There are 5 tracked policy changes affecting CPT 97112, including updates from Sentara Health Plans, CareFirst BlueCross BlueShield, CareSource. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 97112?

Accepted Answer

Payers that have issued tracked updates for CPT 97112 include: Sentara Health Plans, CareFirst BlueCross BlueShield, CareSource, Nevada Medicaid.

Question 3

How do I get notified when CPT 97112 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 97112. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 97112?

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.

97112 Insurance Policy Changes

Authorization Updates - Effective January 1, 2026

Important Outpatient Therapy and Home Health Prior Authorization Entry Guidelines

[Georgia] Prior Authorization Requirement Update

Updates to Limitation Error Codes

Attention Provider Types 24 (Advanced Practice Registered Nurses) and 77 (Physician’s Assistant): Service Limitations Updated