CPT 63650 · SCS · BCBS Federal Employee Program
SCS — Percutaneous Trial at BCBS Federal Employee Program.
How BCBS Federal Employee Program approaches CPT 63650 (SCS — Percutaneous Trial) for prior-authorization review: at last review on 2026-04-27, the policy covers this code with prior authorization required.
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BCBSA EPS 7.01.25 / FEP reference policyCriteria summary
High-level themes from the BCBS Federal Employee Program policy of record for CPT 63650. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 26 weeks of conservative care typically required.
- Imaging concordance documentation required.
- Prior Pre-implant psychological evaluation; SCS trial precedes permanent implant (63685) documentation required (typically with ≥50% relief).
Source: BCBSA EPS 7.01.25 reference — Spinal Cord and Dorsal Root Ganglion Stimulation (FEP follows EPS)
See the full BCBS Federal Employee Program criteria.
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