97130 Insurance Policy Changes

CPT 97130, in plain terms, covers A physical therapist performs additional therapeutic exercises and interventions for an extra 15 minutes beyond the initial session. CPT 97130 is referenced in 6 tracked payer policy changes from Sentara Health Plans, Harvard Pilgrim Health Care, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 97130 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 97130 on AAPC