G9597 No low pecarn ped head traum

Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules

Medicare pricing for G9597

Physician Fee Schedule (CY 2026, RVU26D)

Status M: measurement code, reporting only.

Payer policies and prior authorization for G9597

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

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.