CPT 0201T · Vertebral Augmentation · Medicare (WPS MAC)
Sacroplasty — Bilateral at Medicare (WPS MAC).
How Medicare (WPS MAC) approaches CPT 0201T (Sacroplasty — Bilateral) for prior-authorization review: at last review on 2026-04-26, the policy covers this code without prior authorization.
Free with practitioner sign-in — magic-link email auth, no credit card.
Coverage
Covered
Prior auth
No prior auth
Last reviewed
2026-04-26
Policy number
Clearway-MPG-SacroplastyCriteria summary
High-level themes from the Medicare (WPS MAC) policy of record for CPT 0201T. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 4 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: Clearway Master Payer Guidelines v2025 — Sacroplasty
See the full Medicare (WPS MAC) criteria.
Sign in for verbatim conservative-care language, exact imaging-concordance rules, repeat-procedure thresholds, and the denial-risk score for any specific clinical scenario.
Sign in — free for practitioners →