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PAYER POLICY CHANGES

98985 Insurance Policy Changes

CPT 98985 is referenced in 9 tracked payer policy changes from Independence Blue Cross, Aetna, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 98985 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Watch 98985

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REFERENCE DATA

Payers with rules2
Payers requiring prior auth2
  • Colorado Medicaid · Effective July 1, 2026

    Prior authorization required

    Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column)

  • BCBS Michigan · Effective January 1, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

FREQUENTLY ASKED QUESTIONS

Does BCBS Michigan require prior authorization for 98985?

BCBS Michigan lists 98985 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans, with conditions (list dated October 13, 2026). Verify with the payer before scheduling.

Does Colorado Medicaid require prior authorization for 98985?

Colorado Medicaid lists 98985 on Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column) for medicaid ffs plans (list dated July 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 98985?

There are 9 tracked policy changes affecting CPT 98985, including updates from Independence Blue Cross, Aetna, Blue Cross NC. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 98985?

Payers that have issued tracked updates for CPT 98985 include: Independence Blue Cross, Aetna, Blue Cross NC, Medicare/CMS - Transmittals, Blue Cross & Blue Shield of Mississippi, Indiana Medicaid (IHCP).

How do I get notified when CPT 98985 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 98985. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 98985?

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.

See every payer rule for 98985

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 98985 in one place.

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