CPT 22513 · Vertebral Augmentation · Aetna Better Health Medicaid
Kyphoplasty — Thoracic (1st level) at Aetna Better Health Medicaid.
How Aetna Better Health Medicaid approaches CPT 22513 (Kyphoplasty — Thoracic (1st level)) for prior-authorization review: at last review on 2026-04-26, the policy covers this code with prior authorization required.
Free with practitioner sign-in — magic-link email auth, no credit card.
Clearway-MPG-KyphoplastyCriteria summary
High-level themes from the Aetna Better Health Medicaid policy of record for CPT 22513. 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 — Kyphoplasty
See the full Aetna Better Health 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.
Sign in — free for practitioners →