CPT 64495 · Facet/MBB · Medicare (WPS MAC)
Facet/MBB — Lumbar/Sacral (3rd+ level) at Medicare (WPS MAC).
How Medicare (WPS MAC) approaches CPT 64495 (Facet/MBB — Lumbar/Sacral (3rd+ level)) for prior-authorization review: at last review on 2026-05-09, the policy does not cover this code without prior authorization.
Free with practitioner sign-in — magic-link email auth, no credit card.
L38841Criteria summary
High-level themes from the Medicare (WPS MAC) 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: LCD L38841 (WPS_GHA)
See the full Medicare (WPS MAC) criteria.
Sign in for verbatim conservative-care language, exact imaging-concordance rules, repeat-procedure thresholds, and the denial-risk score for any specific clinical scenario.
Sign in — free for practitioners →