CPT 64494 · Facet/MBB · Oscar Health
Facet/MBB — Lumbar/Sacral (2nd level) at Oscar Health.
How Oscar Health approaches CPT 64494 (Facet/MBB — Lumbar/Sacral (2nd level)) for prior-authorization review: at last review on 2026-05-10, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-10
Policy number
CG047Criteria summary
High-level themes from the Oscar Health policy of record for CPT 64494. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Imaging concordance documentation required.
See the full Oscar Health criteria.
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