CPT 22520 · Lumbar Fusion · Illinois Medicaid (HFS)
Vertebroplasty — Thoracic (legacy) at Illinois Medicaid (HFS).
How Illinois Medicaid (HFS) approaches CPT 22520 (Vertebroplasty — Thoracic (legacy)) for prior-authorization review: at last review on 2025-11-01, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2025-11-01
Criteria summary
High-level themes from the Illinois Medicaid (HFS) policy of record for CPT 22520. Verbatim policy text and per-criterion analysis are available after sign-in.
- Conservative care expectations vary; sign in for specifics.
- Imaging concordance documentation required.
Source: Illinois Medicaid (HFS) Spinal Fusion Coverage
See the full Illinois Medicaid (HFS) criteria.
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