CPT 0628T · Intradiscal · PA Medical Assistance (FFS)
ViaDisc — Lumbar (additional level) at PA Medical Assistance (FFS).
How PA Medical Assistance (FFS) approaches CPT 0628T (ViaDisc — Lumbar (additional level)) for prior-authorization review: at last review on 2026-05-06, the policy does not cover this code without prior authorization.
Free with practitioner sign-in — magic-link email auth, no credit card.
Criteria summary
High-level themes from the PA Medical Assistance (FFS) policy of record for CPT 0628T. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: PA Medical Assistance Provider Handbook & Fee Schedule (FFS)
See the full PA Medical Assistance (FFS) 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 →