HCPCS G9037 is officially defined as "Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified health care professional for the care of the patient (i.e. not for professional education or scheduling) and may include subsequent follow up on the specialist's recommendations; 30 minutes." HCPCS G9037 is referenced in 7 tracked payer policy changes from Independence Blue Cross, Michigan Medicaid - MDHHS, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS G9037 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Independence Blue Cross Medicare Advantage is revising bundling policies effective 10/01/2026. CPT code 99459 (pelvic exam during E/M) is now classified as not eligible for separate reimbursement and has been added to Attachment B. HCPCS codes G9037 and G9038 have been terminated and removed from Attachment C. Billing teams must stop billing these codes separately and ensure providers understand they cannot bill members for these services.
Michigan Medicaid has updated CPT and HCPCS codes effective July 1, 2025, adding new covered codes for various provider types and discontinuing several existing codes. This affects billing for Medicaid, Healthy Michigan Plan, and related programs in Michigan.
Multiple billing code updates effective July 1, 2025: 5 new immunization codes added, 4 codes deleted, 13 codes marked as non-reimbursable, new modifier requirements for off-campus institutional claims, and modifier 27 added for multiple outpatient E/M encounters.
Independence Blue Cross has updated policy 00.01.52ac effective 10/01/2026 to clarify that pelvic exams performed during E/M visits (CPT 99459) are not eligible for separate reimbursement. Additionally, six HCPCS codes (G2061, G2062, G2063, G9037, G9038, Q0239) have been terminated and removed from the bundled services list.
Independence Blue Cross Medicare Advantage is revising its bundled procedure code policy effective 10/01/2026. CPT code 99459 (pelvic exam during E/M service) is now classified as not eligible for separate reimbursement and has been added to Attachment B. Additionally, HCPCS codes G9037 and G9038 have been terminated and removed from Attachment C.
Independence Blue Cross updated policy 00.01.52ac to clarify that CPT 99459 (E/M with pelvic exam) is not eligible for separate reimbursement and cannot be billed to members. Additionally, six HCPCS codes (G2061, G2062, G2063, G9037, G9038, Q0239) have been terminated and removed from the non-reimbursable services list, effective October 1, 2026.
Independence Blue Cross removed HCPCS code G9037 from telemedicine coverage effective 07/01/2025 as part of a routine code update. This is a standard maintenance change to align the policy with current valid HCPCS codes. Billing teams must remove G9037 from their telemedicine billing workflows to prevent claim denials.
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