CPT 64625 · SI Joint · UnitedHealthcare Community Plan of New Jersey
SI Joint RFA (lateral branches) at UnitedHealthcare Community Plan of New Jersey.
How UnitedHealthcare Community Plan of New Jersey 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.
Free with practitioner sign-in — magic-link email auth, no credit card.
2026T0621NCriteria summary
High-level themes from the UnitedHealthcare Community Plan of New Jersey policy of record for CPT 64625. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
See the full UnitedHealthcare Community Plan of New Jersey criteria.
Sign in for verbatim conservative-care language, exact imaging-concordance rules, repeat-procedure thresholds, and the denial-risk score for any specific clinical scenario.
Sign in — free for practitioners →