CPT 0628T · Intradiscal · Sunshine Health (Centene) — Florida Medicaid

ViaDisc — Lumbar (additional level) at Sunshine Health (Centene) — Florida Medicaid.

How Sunshine Health (Centene) — Florida Medicaid 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.

Coverage Not covered

Prior auth No prior auth

InvestigationalInvestigational / experimental

Last reviewed 2026-05-06

Policy numberFL 59G-4.222 / Centene corporate investigational policy

Criteria summary

High-level themes from the Sunshine Health (Centene) — Florida Medicaid 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: Sunshine Health FL Medicaid — investigational/experimental services not covered (Centene corporate policy + FL Medicaid State Plan exclusion under Rule 59G-1.010 F.A.C.)

See the full Sunshine Health (Centene) — Florida Medicaid 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.

ViaDisc — Lumbar (additional level) at Sunshine Health (Centene) — Florida Medicaid.

Criteria summary

See the full Sunshine Health (Centene) — Florida Medicaid criteria.

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