Question 1

What insurance policy changes affect CPT 97605?

Accepted Answer

There are 5 tracked policy changes affecting CPT 97605, including updates from Health Net, Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 97605?

Accepted Answer

Payers that have issued tracked updates for CPT 97605 include: Health Net, Humana.

Question 3

How do I get notified when CPT 97605 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 97605. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 97605?

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.

97605 Insurance Policy Changes

26-073 Updates to the Prior Authorization Requirements

26-074 Updates to the Prior Authorization Requirements

26-075 Updates to the Prior Authorization Requirements

Negative Pressure Wound Therapy - Medicare Advantage (Revised)

26-076 Updates to the Prior Authorization Requirements