CommercialCoverageMedium impact
12.00.05e, Prescription Digital Therapeutics and Mobile-Based Health Management Applications
Independence Blue Cross·PA · Physical Therapy, Occupational Therapy, Neurology +2 more·Medical Policy
Effective date
Dec 29, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated policy 12.00.05e to 12.00.05g, adding 13 new prescription digital therapeutics to the experimental/investigational (non-covered) list and introducing 2 new CPT codes (0733T, 0734T) and 2 new HCPCS codes (E0738, E3200) effective 12/29/2025. Billing teams must update systems to deny claims for these newly designated codes and applications.
Action Required
By 12/29/2025: Billing team must update billing system to flag CPT codes 0733T, 0734T and HCPCS codes E0738, E3200 as non-covered (experimental/investigational) under Independence Blue Cross commercial plans. Configure system to automatically deny claims submitted with these codes and display message: 'Service identified as experimental/investigational and not covered.' Update claim denial templates and provider communications to reference policy 12.00.05g. Notify providers that services associated with the 13 newly added prescription digital therapeutics applications are not billable. Any claims submitted with these codes or for the 13 new applications will be denied; patients should not be billed for these services.