CommercialAdministrativeLow impact
10.03.01o, Outpatient Physical Medicine, Rehabilitation, and Habilitation Services
Independence Blue Cross·Physical Therapy, Occupational Therapy, PM&R (Physical Medicine & Rehab) +1 more·Medical Policy
We identified it
Jun 19, 2026
Summary
This is a reissue with no substantive changes to Independence Blue Cross Commercial Policy 10.03.01o on Outpatient Physical Medicine, Rehabilitation, and Habilitation Services. The policy was last reviewed and reissued on 09/18/2026 per the company's annual review process. Key coverage requirements, modifier mandates (GO for OT, GP for PT), experimental/investigational exclusions (including LLLT and CPT 97037), and state mandate considerations for Autism Spectrum Disorders remain unchanged.
Action Required
No immediate action required. This is a routine annual reissue with no changes to coverage, billing requirements, or coding guidance. Billing team should file or archive this reissue version (09/18/2026) for policy reference purposes. Verify that existing billing system configurations already reflect the established requirements: (1) Modifier GO appended for OT services, (2) Modifier GP appended for PT services, (3) CPT 97037 marked as experimental/investigational (not covered), and (4) Low-level laser therapy (LLLT) documented as not covered. No system updates or workflow changes needed at this time.