CPT 64480 · Epidural · UnitedHealthcare Community Plan of Maryland
TFESI — Cervical/Thoracic (add'l level) at UnitedHealthcare Community Plan of Maryland.
How UnitedHealthcare Community Plan of Maryland approaches CPT 64480 (TFESI — Cervical/Thoracic (add'l level)) for prior-authorization review: at last review on 2026-04-27, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-04-27
Policy number
2026T0616MCriteria summary
High-level themes from the UnitedHealthcare Community Plan of Maryland 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.
See the full UnitedHealthcare Community Plan of Maryland criteria.
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