CPT 64480 · Epidural · Medicare (Novitas MAC)
TFESI — Cervical/Thoracic (add'l level) at Medicare (Novitas MAC).
How Medicare (Novitas MAC) approaches CPT 64480 (TFESI — Cervical/Thoracic (add'l level)) for prior-authorization review: at last review on 2026-04-09, the policy covers this code without prior authorization.
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L36920Criteria summary
High-level themes from the Medicare (Novitas MAC) policy of record for CPT 64480. 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: LCD L36920 — Epidural Steroid Injections for Pain Management (Novitas)
See the full Medicare (Novitas MAC) criteria.
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