Humana physical therapy coverage: codes and prior authorization
Unofficial source · confirm with the payer Some facts on this page come from a secondary source (a professional association, a billing guide or a published summary), not from the payer's own documents. Each one is marked and links to where we read it; confirm it with the payer before you rely on it.
By Javier Alvarez · Updated · 1 min read
1 row: Humana. Public policy, not the member's benefits.
Humana
Humana commercial, Medicare Advantage and dual plans, outpatient physical therapy · All states
Unofficial source · confirm with the payer: some facts in this row come from a secondary source, not the payer.
| 97110 | Listed (on the prior authorization list the vendor publishes for Humana.) [1] Unofficial source · confirm with the payer |
|---|---|
| 97112 | Listed (on the prior authorization list the vendor publishes for Humana.) [1] Unofficial source · confirm with the payer |
| 97140 | Listed (on the prior authorization list the vendor publishes for Humana.) [1] Unofficial source · confirm with the payer |
| 97164 | Listed (on the prior authorization list the vendor publishes for Humana.) [1] Unofficial source · confirm with the payer |
| 97530 | Listed (on the prior authorization list the vendor publishes for Humana.) [1] Unofficial source · confirm with the payer |
| 97750 | Listed (on the prior authorization list the vendor publishes for Humana.) [1] Unofficial source · confirm with the payer |
| Where it applies | Cohere Health says it is the exclusive preauthorization and utilization management vendor for Humana musculoskeletal services in all 50 states and Washington, DC, for most commercial and Medicare plans. [1] Unofficial source · confirm with the payer |
| Prior authorization | Physical, occupational and speech therapy codes are on the list of services practices must request through Cohere, including 97110, 97112, 97140, 97164, 97530 and 97750. The page does not list the evaluation codes 97161 to 97163. [1] Unofficial source · confirm with the payer |
| Managed care plans | Cohere says it will not be used for Medicare HMO members in FL, CA and HI. Those members keep getting authorizations through their primary care provider. [1] Unofficial source · confirm with the payer |
| Also | Cohere says an approval is not a guarantee of payment, and tells practices to check Humana's official prior authorization list at humana.com/pal for current requirements. Outpatient therapy in a skilled nursing facility billed under Medicare Part B also goes through Cohere. [1] Unofficial source · confirm with the payer |
- Cohere Health Learning Center: Humana Prior Authorization List (PAL), Musculoskeletal Services (July 1, 2026) (secondary source), checked October 30, 2026
What Humana's documents say
The table above has every field we found for Humana, with numbered sources. In short:
- Prior authorization. Physical, occupational and speech therapy codes are on the list of services practices must request through Cohere, including 97110, 97112, 97140, 97164, 97530 and 97750. The page does not list the evaluation codes 97161 to 97163. (Unofficial source · confirm with the payer)
- Where it applies. Cohere Health says it is the exclusive preauthorization and utilization management vendor for Humana musculoskeletal services in all 50 states and Washington, DC, for most commercial and Medicare plans. (Unofficial source · confirm with the payer)
- Codes. 97110, 97112, 97140, 97164, 97530 and 97750 are listed. (Unofficial source · confirm with the payer)
Physical therapy coverage at other national payers
Medicare, UnitedHealthcare Medicare Advantage, UnitedHealthcare Commercial, Aetna, Cigna and TRICARE.
Check Humana's claim against the row
Before the claim goes out, compare it with the row above: the evaluation code matches the complexity you documented, the timed codes fit the minutes, any prior authorization covers the visit, and the plan of care is signed when the payer asks for it. The physical therapy table compares Humana with every other payer we checked.