CPT 64580 · PNS · UnitedHealthcare Community Plan (Medicaid)
PNS — Open Electrode Placement (neuromuscular) at UnitedHealthcare Community Plan (Medicaid).
How UnitedHealthcare Community Plan (Medicaid) approaches CPT 64580 (PNS — Open Electrode Placement (neuromuscular)) 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 UnitedHealthcare Community Plan (Medicaid) policy of record for CPT 64580. 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
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