CPT 64492 · Facet/MBB · UnitedHealthcare Community Plan of New Jersey
Facet/MBB — Cervical/Thoracic (3rd+ level) at UnitedHealthcare Community Plan of New Jersey.
How UnitedHealthcare Community Plan of New Jersey approaches CPT 64492 (Facet/MBB — Cervical/Thoracic (3rd+ 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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2026T0004UUCriteria summary
High-level themes from the UnitedHealthcare Community Plan of New Jersey policy of record for CPT 64492. 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 New Jersey criteria.
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