CPT 64580 · PNS · Maryland Physicians Care
PNS — Open Electrode Placement (neuromuscular) at Maryland Physicians Care.
How Maryland Physicians Care approaches CPT 64580 (PNS — Open Electrode Placement (neuromuscular)) for prior-authorization review: at last review on 2026-05-06, the policy covers this code with prior authorization required.
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NIA IPM Guidelines (2024)Criteria summary
High-level themes from the Maryland Physicians Care policy of record for CPT 64580. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 26 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: MPC / Evolent (NIA) IPM Guidelines — Peripheral Nerve Stimulation (Reactiv8)
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