CPT 64628 · Intradiscal · Maryland Physicians Care
Intracept — Basivertebral Nerve Ablation (1st level) at Maryland Physicians Care.
How Maryland Physicians Care approaches CPT 64628 (Intracept — Basivertebral Nerve Ablation (1st level)) 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.
NIA IPM Guidelines (2024)Criteria summary
High-level themes from the Maryland Physicians Care policy of record for CPT 64628. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: MPC / Evolent (NIA) IPM Guidelines — BVN Ablation (investigational)
See the full Maryland Physicians Care 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 →