Outpatient Physical and Occupational Therapy Services
J15 · Effective Oct 1, 2015
20 active Medicare policies list 97605, and 13 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
JE · Effective Nov 28, 2021
JF · Effective Nov 28, 2021
J9 · Effective Dec 7, 2017
JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
J5 · Effective Apr 16, 2018
J8 · Effective Apr 16, 2018
13 policies from 13 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 97605 |
|---|---|---|
| Negative Pressure Wound Therapy | Dec 13, 2023 | Covered |
| Policy | Effective | Status of 97605 |
|---|---|---|
| Vacuum Assisted Wound Therapy in the Outpatient Setting | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 97605 |
|---|---|---|
| Negative Pressure Wound Therapy in the Outpatient Setting | May 1, 2026 | Covered |
National · Effective Jan 1, 2024
National · Effective Jan 1, 2024
National · Effective Oct 1, 2026
J6 · Effective Apr 1, 2026
National · Effective Jun 4, 2026
National · Effective Oct 1, 2026
National · Effective Oct 1, 2026
JL · Effective Jan 1, 2026
J9 · Effective Jan 1, 2026
J5 · Effective Oct 1, 2026
| Policy | Effective | Status of 97605 |
|---|---|---|
| Negative Pressure Wound Therapy in the Outpatient Setting | May 1, 2026 | Covered |
| Policy | Effective | Status of 97605 |
|---|---|---|
| Negative Pressure Wound Therapy in the Outpatient Setting | May 1, 2026 | Covered |
| Policy | Effective | Status of 97605 |
|---|---|---|
| Negative Pressure Wound Therapy in the Outpatient Setting | May 1, 2026 | Covered |
| Policy | Effective | Status of 97605 |
|---|---|---|
| EOCCO Specialty Therapies Code List | May 1, 2026 | Prior auth required |
| Policy | Effective | Status of 97605 |
|---|---|---|
| Negative Pressure Wound Therapy | Aug 3, 2026 | Covered |
| Policy | Effective | Status of 97605 |
|---|---|---|
| Negative Pressure Wound Therapy in the Outpatient Setting | Apr 1, 2026 | Covered |
| Policy | Effective | Status of 97605 |
|---|---|---|
| Negative Pressure Wound Therapy | Jun 1, 2026 | Covered |
| Policy | Effective | Status of 97605 |
|---|---|---|
| The Health Plan MSK PTOT Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 97605 |
|---|---|---|
| Negative Pressure Wound Therapy | Jun 1, 2026 | Covered |
| Policy | Effective | Status of 97605 |
|---|---|---|
| Negative Pressure Wound Therapy | Jun 1, 2026 | Covered |