CPT 64624 · Radiofrequency Ablation · Anthem BCBS
Genicular Nerve RFA at Anthem BCBS.
How Anthem BCBS approaches CPT 64624 (Genicular Nerve RFA) for prior-authorization review: at last review on 2026-05-02, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-02
Criteria summary
High-level themes from the Anthem BCBS policy of record for CPT 64624. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Prior Genicular nerve diagnostic block(s) (64454) documentation required (typically with ≥80% relief).
Source: Anthem Medical Policy
See the full Anthem BCBS criteria.
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