Question 1

What insurance policy changes affect CPT 97152?

Accepted Answer

There are 3 tracked policy changes affecting CPT 97152, including updates from Cigna, Indiana Medicaid (IHCP). Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 97152?

Accepted Answer

Payers that have issued tracked updates for CPT 97152 include: Cigna, Indiana Medicaid (IHCP).

Question 3

How do I get notified when CPT 97152 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 97152. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 97152?

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.

97152 Insurance Policy Changes

Updates to the Code Editing Policy and Guidelines

Clinical, reimbursement, and administrative policy updates

BT202627: IHCP announces changes to applied behavior analysis (ABA) therapy services