CPT 64490 · Facet/MBB · North Carolina Medicaid
Facet/MBB — Cervical/Thoracic (1st level) at North Carolina Medicaid.
How North Carolina 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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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-06
Criteria summary
High-level themes from the North Carolina 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.
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