CPT 64479 · Epidural · Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid
TFESI — Cervical/Thoracic (1st level) at Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid.
How Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid approaches CPT 64479 (TFESI — Cervical/Thoracic (1st level)) 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 (2026-06-14)Criteria summary
High-level themes from the Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid policy of record for CPT 64479. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 4 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: Carelon Clinical Appropriateness Guidelines — Interventional Pain Management
See the full Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid criteria.
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