CPT 64490 · Facet/MBB · Alabama Medicaid
Facet/MBB — Cervical/Thoracic (1st level) at Alabama Medicaid.
How Alabama Medicaid approaches CPT 64490 (Facet/MBB — Cervical/Thoracic (1st level)) for prior-authorization review: at last review on 2026-05-07, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-07
Criteria summary
High-level themes from the Alabama Medicaid policy of record for CPT 64490. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 2 weeks of conservative care typically required.
Source: Alabama Medicaid Agency
See the full Alabama Medicaid criteria.
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