Question 1

What insurance policy changes affect CPT 97811?

Accepted Answer

There are 4 tracked policy changes affecting CPT 97811, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 97811?

Accepted Answer

Payers that have issued tracked updates for CPT 97811 include: Aetna.

Question 3

How do I get notified when CPT 97811 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 97811. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 97811?

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.

97811 Insurance Policy Changes

Acupuncture and Dry Needling (CPB 0135, reviewed 2026-03-25)

Dry Eyes (CPB 0457, reviewed 2026-07-29)

Enuresis (CPB 0431, reviewed 2026-07-01)

Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments (CPB 0788, reviewed 2025-11-19)