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Code edit notification

Notification Number: 3530

Effective date: 3/1/2018

Notification date: 12/1/2017

Category: CPT

Topic: Therapy – group therapy

Providers affected:

  • Inpatient/Outpatient Facilities
  • Physician/Health Care Providers
What is changing?

We will not reimburse charges for CPT code 97150, therapeutic procedure(s), group (two or more individuals).

Why is Humana implementing this change?

Humana's policy on physical and occupational therapy has been updated to indicate that the services above are not covered.

For more information, refer to Humana's Medical and Pharmacy Coverage Policies page and search for “97150.”

Impacted products

  • Commercial fully insured products


*All edits previously posted on Humana.com/providers for fully insured commercial Humana members may be applied to self-funded members, when requested by the self-funded group.