CPT 64625 · SI Joint · Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid
SI Joint RFA (lateral branches) at Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid.
How Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid approaches CPT 64625 (SI Joint RFA (lateral branches)) for prior-authorization review: at last review on 2026-05-06, the policy does not cover this code with prior authorization required.
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Carelon IPM MSK01 (2026-06-14)Criteria summary
High-level themes from the Simply Healthcare Plans (Anthem/Elevance) — Florida Medicaid policy of record for CPT 64625. Verbatim policy text and per-criterion analysis are available after sign-in.
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