CPT 0201T · SI Joint · Georgia Medicaid
Sacroplasty — Bilateral at Georgia Medicaid.
How Georgia Medicaid approaches CPT 0201T (Sacroplasty — Bilateral) for prior-authorization review: at last review on 2026-05-06, the policy covers this code with prior authorization required.
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Criteria summary
High-level themes from the Georgia Medicaid policy of record for CPT 0201T. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: Georgia Medicaid Coverage Policy - Interventional Pain Procedures
See the full Georgia Medicaid criteria.
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