Optimum Healthcare policies

Search Optimum Healthcare's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

4 policies name 97113, those listing the fewest codes first. A policy that names a code may also list it as excluded.

Optimum Healthcare policies
Policy	Details	Codes	Source
HEDIS Measurement Year (MY) 2020 Physician documentation guidelines and administrative codes	OH	567	Original policy ↗
Standard Local Prior Authorization Code List	Commercial · GA	3,068	Original policy ↗
Colorado Prior Authorization List	Commercial · CO	3,281	Original policy ↗
Prior Authorization List	Commercial · NV	3,304	Original policy ↗

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Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

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