CPT 64490 · Facet/MBB · Michigan Medicaid
Facet/MBB — Cervical/Thoracic (1st level) at Michigan Medicaid.
How Michigan Medicaid approaches CPT 64490 (Facet/MBB — 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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Criteria summary
High-level themes from the Michigan Medicaid policy of record for CPT 64490. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: Michigan Department of Health and Human Services - Medicaid Coverage
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