CPT 64495 · Facet/MBB · Jai Medical Systems — Maryland Medicaid
Facet/MBB — Lumbar/Sacral (3rd+ level) at Jai Medical Systems — Maryland Medicaid.
How Jai Medical Systems — Maryland Medicaid 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 without prior authorization.
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L34892Criteria summary
High-level themes from the Jai Medical Systems — Maryland Medicaid policy of record for CPT 64495. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: Maryland Medicaid Professional Services Provider Manual & Fee Schedule (FFS)
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