CPT 22513 · Vertebral Augmentation · UPMC for You — PA HealthChoices
Kyphoplasty — Thoracic (1st level) at UPMC for You — PA HealthChoices.
How UPMC for You — PA HealthChoices approaches CPT 22513 (Kyphoplasty — Thoracic (1st level)) for prior-authorization review: at last review on 2026-05-06, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-06
Policy number
L35130Criteria summary
High-level themes from the UPMC for You — PA HealthChoices 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.
See the full UPMC for You — PA HealthChoices criteria.
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