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.
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What to do
by Jan 1, 2026 · 5 steps
01Billing team must implement new Visit Complexity Add-On Code G2211 in billing system per Policy #CR-101.
02Update 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).
03Stop billing CPT 93042 with 93010 or 99285 as these will be denied per NCCI edits.
04Prepare for new editing system launch in Q1 2026.
05Update encounter forms and EMR templates to reflect new conservative therapy documentation requirements.
Codes mentioned
G2211438899304293010992859304093041
Original notice
January 2026
selecthealth.org · Always check the source before changing claims.