99461 Insurance Policy Changes

CPT 99461, in plain terms, covers Your doctor's initial newborn care visit on the day of birth, performed outside a hospital setting. CPT 99461 is referenced in 4 tracked payer policy changes from New Mexico Medicaid, Oregon Health Plan, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 99461 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 99461 on AAPC