CPT 22800 ·
22800
22800 (22800) — payor coverage and prior-authorization requirements across all Medicare MACs, commercial payors, BCBS plans, and Medicaid programs tracked by Rubrica.
Free with practitioner sign-in — magic-link email auth, no credit card.
Rubrica tracks payor coverage for CPT 22800 (22800) across 29 payors — every Medicare MAC, the major commercial plans, the BCBS family, all 50-state Medicaid programs, and selected workers' comp and auto/PIP carriers. Aggregate coverage patterns are shown below; full payor-specific criteria, source citations, and last-reviewed dates are available to signed-in practitioners.
Top payors covering CPT 22800
Sample of 12 payors with coverage for this code. Sign in for the complete payor list, verbatim criteria, denial-risk score, and source citations for each.
| Payor | Coverage | Prior auth |
|---|---|---|
| Ambetter | Covered | Prior auth |
| BCBS Alabama | Covered | Prior auth |
| BCBS Federal Employee Program | Covered | Prior auth |
| BCBS Massachusetts | Covered | Prior auth |
| BCBS Michigan | Covered | Prior auth |
| BCBS Montana | Covered | Prior auth |
| BCBS New Mexico | Covered | Prior auth |
| BCBS Oklahoma | Covered | Prior auth |
| BCBS Tennessee | Covered | Prior auth |
| CareFirst BCBS | Covered | Prior auth |
| Excellus BCBS | Covered | Prior auth |
| Florida Blue | Covered | Prior auth |
Coverage themes for CPT 22800
Common patterns across the 29 payors we track. Specific criteria per payor are available after sign-in.
Most payors require ≥24 weeks of conservative care before approving 22800.
29 of 29 payors require imaging concordance documentation.
Of the 29 payors with coverage records for CPT 22800, 21 require prior authorization, 8 cover without prior authorization, and 0 flag the procedure as investigational or experimental under current criteria.
See the policy for every payor.
Sign in to see verbatim coverage criteria, conservative-care duration requirements, imaging concordance rules, and the documentation each payor wants in the submission.
Sign in — free for practitioners →