Question 1

What insurance policy changes affect HCPCS G0397?

Accepted Answer

There are 2 tracked policy changes affecting HCPCS G0397, including updates from Oregon Health Plan, New Jersey Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for HCPCS G0397?

Accepted Answer

Payers that have issued tracked updates for HCPCS G0397 include: Oregon Health Plan, New Jersey Medicaid.

Question 3

How do I get notified when HCPCS G0397 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to HCPCS G0397. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for HCPCS G0397?

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.

G0397 Insurance Policy Changes

Notice of intent – OHA will amend the Medicaid State Plan to increase fee-for-service primary care rates.

Newsletter Vol. 29, No.10