Question 1

What insurance policy changes affect CPT 97036?

Accepted Answer

There are 4 tracked policy changes affecting CPT 97036, including updates from Aetna, Sentara Health Plans, CareSource. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 97036?

Accepted Answer

Payers that have issued tracked updates for CPT 97036 include: Aetna, Sentara Health Plans, CareSource.

Question 3

How do I get notified when CPT 97036 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 97036. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 97036?

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.

97036 Insurance Policy Changes

Physical Therapy (CPB 0325, reviewed 2026-06-02)

Pool Therapy, Aquatic Therapy or Hydrotherapy (CPB 0174, reviewed 2026-04-21)

Authorization Updates - Effective January 1, 2026

[Georgia] Prior Authorization Requirement Update