Question 1

What insurance policy changes affect CPT 96137?

Accepted Answer

There are 6 tracked policy changes affecting CPT 96137, including updates from Aetna, Nevada Medicaid, Colorado Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 96137?

Accepted Answer

Payers that have issued tracked updates for CPT 96137 include: Aetna, Nevada Medicaid, Colorado Medicaid, Harvard Pilgrim Health Care, Healthfirst, Humana.

Question 3

How do I get notified when CPT 96137 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 96137. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 96137?

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.

96137 Insurance Policy Changes

Attention Deficit/Hyperactivity Disorder (CPB 0426, reviewed 2026-07-07)

Prior Authorization Updated in the Medicaid Management Information System for Neuropsychological, Psychological, and Developmental Testing Codes and Billing Guides Updated

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2600535 - 03/2026)

Update: Telehealth flexibilities for Medicare members

Reimbursement Policies Updated in August 2026

Psychological and Neuropsychological Testing - Medicare Advantage (New)