97037 CPT® code: payer coverage and prior authorization13 of 13 payer prior-auth lists that name 97037 require prior authorization or set conditions: CarePlus Health Plans, Humana.
97037 appears in 27 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Autism Spectrum Disorders (0648) | listed, no stance (range 97010-97546) | Oct 2, 2025 | payer document |
| Aetna | Back Pain - Invasive Procedures (0016) | listed, no stance (range 97010-97039) | Oct 6, 2026 | payer document |
| Aetna | Back Pain - Invasive Procedures (0016) | listed, no stance (range 97010-97799) | Oct 6, 2026 | payer document |
| Aetna | Back Pain - Invasive Procedures (0016) | listed, no stance (range 97010-97139) | Oct 6, 2026 | payer document |
| Aetna | Back Pain - Invasive Procedures (0016) | listed, no stance (range 97010-97763) | Oct 6, 2026 | payer document |
| Aetna | Burn Garments (0062) | listed, no stance (range 97032-97039) | Jan 15, 2026 | payer document |
| Aetna | Chiropractic Services (0107) | listed, no stance (range 97010-97799) | Apr 7, 2026 | payer document |
| Aetna | Chronic Pain Rehabilitation Programs (0237) | listed, no stance (range 97010-97546) | Apr 23, 2026 | payer document |
| Aetna | Cold Laser and High-Power Laser Therapies (0363) High-power laser therapy (class IV therapeutic laser) | not covered | Jul 15, 2026 | payer document |
| Aetna | Complex Regional Pain Syndrome (CRPS): Treatments (0447) | listed, no stance (range 97010-97168) | Jul 16, 2026 | payer document |
| Aetna | Eagle's and Ernest Syndrome (0400) | listed, no stance (range 97032-97039) | Jun 30, 2026 | payer document |
| Aetna | Electrodiagnostic Testing (0502) | listed, no stance (range 97010-97799) | Jul 29, 2026 | payer document |
| Aetna | Functional Electrical Stimulation and Neuromuscular Electrical Stimulation (0677) | listed, no stance (range 97010-97763) | Sep 10, 2026 | payer document |
| Aetna | Hip Arthroplasty (0287) | listed, no stance (range 97010-97546) | Sep 23, 2026 | payer document |
| Aetna | Home Health Aides (0218) | listed, no stance (range 97010-97799) | Sep 10, 2026 | payer document |
| Aetna | Intervertebral Disc Prostheses (0591) | listed, no stance (range 97010-97039) | Sep 18, 2026 | payer document |
| Aetna | Knee Arthroplasty (0660) | listed, no stance (range 97010-97799) | Oct 8, 2026 | payer document |
| Aetna | Standing Frames, Tables, and Transfer Boards (0481) | listed, no stance (range 97001-97763) | Jul 2, 2026 | payer document |
| Aetna | Total Ankle Arthroplasty (0645) | listed, no stance (range 97001-97799) | Sep 14, 2026 | payer document |
| Aetna | Transforaminal Epidural Injections (0722) | listed, no stance (range 97010-97530) | Oct 20, 2025 | payer document |
| Aetna | Vasectomy Procedures and Chronic Scrotal Content Pain (0027) | listed, no stance (range 97010-97799) | Jan 27, 2026 | payer document |
| Aetna | Vulvodynia and Vulvar Vestibulitis Treatments (0759) | covered if criteria are met (range 97034-97039) | Nov 12, 2025 | payer document |
| Blue Cross & Blue Shield of Mississippi | Lowlevel Laser Therapy | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Low-Level Laser Therapy | covered if criteria are met | Mar 1, 2026 | payer document |
| Blue Cross & Blue Shield of Rhode Island | Low-Level Laser Therapy sad | covered if criteria are met | Mar 1, 2026 | payer document |
| Blue Cross Blue Shield of Massachusetts | Low Level Laser Therapy (522) | unproven / investigational | payer document | |
| Blue Cross NC | Rehabilitative Therapies | listed, no stance | Sep 1, 2025 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Low-Level Laser Therapy (MED201.045) | listed, no stance | Sep 15, 2026 | payer document |
| Premera Blue Cross | Non-covered Services and Procedures Page | 9 of 30 | ∞ | listed, no stance | Jun 1, 2026 | payer document |
| Regence | Low-Level Laser Therapy (Medicine 105) | listed, no stance | Jun 1, 2026 | payer document |
Prior authorization required or conditional in IN, MS, VA.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.