12 commercial payer policies list G0277. 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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12 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 G0277 |
|---|---|---|
| Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments | Feb 20, 2024 | Covered |
| Autism Spectrum Disorders | Dec 5, 2023 | Covered |
| Hypertrophic Scars and Keloids | Jun 22, 2023 | Covered |
| Infertility | Feb 15, 2024 | Covered |
| Tinnitus Treatments | Feb 16, 2024 | Covered |
| Xerostomia: Selected Treatments | May 8, 2023 | Covered |
| Policy | Effective | Status of G0277 |
|---|---|---|
| Autism Spectrum Disorders/Pervasive Developmental Disorders: Assessment and Treatment | May 15, 2026 | Not covered |
| Hyperbaric and Topical Oxygen Therapies | May 15, 2026 | Covered |
| Policy | Effective | Status of G0277 |
|---|---|---|
| Hyperbaric Oxygen Therapy (Systemic/Topical) | Jul 1, 2026 | Covered |
| Policy | Effective | Status of G0277 |
|---|---|---|
| Hyperbaric Oxygen Therapy | Jan 1, 2026 | Covered |
| Policy | Effective | Status of G0277 |
|---|---|---|
| Hyperbaric Oxygen Therapy and Topical Oxygen Therapy | May 1, 2026 | Covered |
| Policy | Effective | Status of G0277 |
|---|---|---|
| Hyperbaric Oxygen Therapy and Topical Oxygen Therapy | May 1, 2026 | Covered |