Outpatient Physical and Occupational Therapy Services
J15 · Effective Oct 1, 2015
17 active Medicare policies list 96125, and 6 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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J15 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J5 · Effective Oct 1, 2015
J8 · Effective Oct 1, 2015
JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
National · Effective Oct 1, 2026
6 policies from 6 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 96125 |
|---|---|---|
| Neuropsychological and Psychological Testing | Apr 6, 2023 | Covered |
| Policy | Effective | Status of 96125 |
|---|---|---|
| Physical Therapy (PT) and Occupational Therapy (OT) Services | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 96125 |
|---|---|---|
| Physical Therapy (PT) and Occupational Therapy (OT) Services | Jan 1, 2026 | Covered |
National · Effective Oct 1, 2025
National · Effective Oct 1, 2026
J6 · Effective Apr 1, 2026
National · Effective Jun 4, 2026
National · Effective Oct 1, 2025
J5 · Effective Oct 31, 2024
JL · Effective Oct 1, 2025
National · Effective Aug 6, 2026
| Policy | Effective | Status of 96125 |
|---|---|---|
| Physical Therapy (PT) and Occupational Therapy (OT) Services | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 96125 |
|---|---|---|
| Physical Therapy (PT) and Occupational Therapy (OT) Services | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 96125 |
|---|---|---|
| EOCCO Specialty Therapies Code List | May 1, 2026 | Prior auth required |