CommercialCoverageHigh impact
January 2026
SelectHealth·UT · PM&R (Physical Medicine & Rehab), Pain Management, Physical Therapy +5 more·Policy Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Select Health published 14 policy updates effective January 1, 2026, including a new Visit Complexity Add-On Code G2211 policy and significant changes to physical therapy requirements across multiple procedures. Most notably, conservative therapy now requires minimum 12 PT/chiropractic visits within 6 weeks (previously varied), and several procedure-specific criteria were updated.
Action Required
By January 1, 2026: Billing team must implement new Visit Complexity Add-On Code G2211 in billing system per Policy #CR-101. Update all physical medicine procedure prior authorization requirements to mandate 12 PT/chiropractic visits within 6-week period within previous year (at least 4 in-person recommended). Stop billing CPT 93042 with 93010 or 99285 as these will be denied per NCCI edits. Prepare for new editing system launch in Q1 2026. Update encounter forms and EMR templates to reflect new conservative therapy documentation requirements.