CPT 63650 · SCS · BCBS Tennessee
SCS — Percutaneous Trial at BCBS Tennessee.
How BCBS Tennessee approaches CPT 63650 (SCS — Percutaneous Trial) for prior-authorization review: at last review on 2026-01-08, the policy covers this code with prior authorization required.
Free with practitioner sign-in — magic-link email auth, no credit card.
Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-01-08
Policy number
BCBS-TN MPM (Spinal Cord Stimulation)Criteria summary
High-level themes from the BCBS Tennessee 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 diagnostic procedure documentation required.
Source: BCBS-TN Medical Policy — Spinal Cord Stimulation for the Treatment of Pain
See the full BCBS Tennessee 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 →