CPT 62362 · Intrathecal Pump · Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid
Pain Pump — Programmable Pump Insertion at Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid.
How Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid approaches CPT 62362 (Pain Pump — Programmable Pump Insertion) for prior-authorization review: at last review on 2026-05-06, the policy covers this code with prior authorization required.
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Carelon IPM (MSK01) / Anthem CG-SURG-15 (related)Criteria summary
High-level themes from the Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid policy of record for CPT 62362. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 26 weeks of conservative care typically required.
- Prior Successful intrathecal trial demonstrating ≥50% pain relief plus functional improvement documentation required (typically with ≥50% relief).
Source: Anthem Medical Policy / Carelon IPM — Intrathecal Drug Delivery (Pain & Spasticity)
See the full Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid criteria.
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