4 commercial payer policies list S9117. 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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4 policies from 2 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of S9117 |
|---|---|---|
| Back Pain - Noninvasive Treatments | Apr 26, 2023 | Covered |
| Work Hardening Programs | Apr 4, 2023 | Covered |
| Policy | Effective | Status of S9117 |
|---|---|---|
| Chiropractic Care | Dec 15, 2025 | Not covered |
| Occupational Therapy | Dec 15, 2025 | Not covered |