CPT 0200T · Vertebral Augmentation · AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoices
Sacroplasty — Unilateral at AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoices.
How AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoices approaches CPT 0200T (Sacroplasty — Unilateral) for prior-authorization review: at last review on 2026-05-06, the policy does not cover this code with prior authorization required.
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eviCore CMM-607Criteria summary
High-level themes from the AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoices policy of record for CPT 0200T. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: eviCore CMM-607 — Sacroplasty (EIU; AC Family / Keystone First)
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