May 2026 Policy Update Digest: Oscar tightens RFA threshold to ≥80%, TRICARE adds basivertebral nerve ablation, UHC expands vertebroplasty coverage
The most clinically meaningful change this month: Oscar Health's CG047 v9 tightened the diagnostic-block relief threshold for radiofrequency ablation from ≥50% to ≥80% — a 30-percentage-point shift that affects every cervical and lumbar RFA prior auth submitted to Oscar. Also covered: TRICARE adds CPT 64628 (basivertebral nerve ablation) per TPM Change 48; UHC Community Plan vertebroplasty/kyphoplasty (22510–22515) effective 2026-05-01; and what to watch for in the CMS Q3 quarterly file expected mid-June.
Read the digest →