CPT 63650 · SCS · Geisinger Health Plan — PA HealthChoices
SCS — Percutaneous Trial at Geisinger Health Plan — PA HealthChoices.
How Geisinger Health Plan — PA HealthChoices approaches CPT 63650 (SCS — Percutaneous Trial) for prior-authorization review: at last review on 2026-05-06, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-06
Policy number
Cohere Pain — SCSCriteria summary
High-level themes from the Geisinger Health Plan — PA HealthChoices 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.
See the full Geisinger Health Plan — PA HealthChoices criteria.
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