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Medical Policy Implementation: Sensory Integration Therapy and Auditory Integration Therapy

Effective July 1, 2015, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain claims for sensory integration therapy for members and their dependents enrolled in certain self-insured employer group health insurance plans that have opted out of the 2010 New Jersey State Autism mandate.

Based on the guidelines of our medical policy, Sensory Integration Therapy and Auditory Integration Therapy, CPT® code 97533 submitted on claims for services provided on and after July 1, 2015 will be denied as an investigational/experimental service for patients who are enrolled in self-insured employer group health insurance plans that have opted out of the 2010 New Jersey State Autism mandate.

Review this revised policy in our online Medical Policy Manual.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service July 1, 2015 and after.

CPT® is a registered mark of the American Medical Association.
 

Published on: March 31, 2015, 12:00 p.m. ET
Last updated on: November 24, 2020, 23:33 p.m. ET