CPT 64495 · Facet/MBB · Highmark Wholecare — PA HealthChoices
Facet/MBB — Lumbar/Sacral (3rd+ level) at Highmark Wholecare — PA HealthChoices.
How Highmark Wholecare — PA HealthChoices approaches CPT 64495 (Facet/MBB — Lumbar/Sacral (3rd+ level)) for prior-authorization review: at last review on 2026-05-06, the policy does not cover this code with prior authorization required.
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HealthHelp IPM — Facet Joint InterventionsCriteria summary
High-level themes from the Highmark Wholecare — PA HealthChoices policy of record for CPT 64495. Verbatim policy text and per-criterion analysis are available after sign-in.
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