CPT 22523 · Vertebral Augmentation · California Medicaid (Medi-Cal)
Kyphoplasty — Thoracic (legacy) at California Medicaid (Medi-Cal).
How California Medicaid (Medi-Cal) approaches CPT 22523 (Kyphoplasty — Thoracic (legacy)) for prior-authorization review: at last review on 2026-05-06, the policy covers this code with prior authorization required.
Free with practitioner sign-in — magic-link email auth, no credit card.
Criteria summary
High-level themes from the California Medicaid (Medi-Cal) policy of record for CPT 22523. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: California Medicaid (Medi-Cal) Coverage for Vertebral Augmentation
See the full California Medicaid (Medi-Cal) 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 →