CPT 64555 · PNS · CareFirst Medicaid Community Plan
PNS — Percutaneous Lead Trial/Placement at CareFirst Medicaid Community Plan.
How CareFirst Medicaid Community Plan approaches CPT 64555 (PNS — Percutaneous Lead Trial/Placement) for prior-authorization review: at last review on 2026-04-26, the policy does not cover this code with prior authorization required.
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Clearway-MPG-PNS_Reactiv8Criteria summary
High-level themes from the CareFirst Medicaid Community Plan policy of record for CPT 64555. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
Source: Clearway Master Payer Guidelines v2025 — PNS_Reactiv8
See the full CareFirst Medicaid Community Plan criteria.
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