CPT 64633 · RFA · Johns Hopkins HealthCare (Employer Health)
RFA — Cervical/Thoracic Facet (1st level) at Johns Hopkins HealthCare (Employer Health).
How Johns Hopkins HealthCare (Employer Health) approaches CPT 64633 (RFA — Cervical/Thoracic Facet (1st level)) for prior-authorization review: at last review on 2025-01-01, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2025-01-01
Policy number
eviCore CMM-208Criteria summary
High-level themes from the Johns Hopkins HealthCare (Employer Health) policy of record for CPT 64633. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 4 weeks of conservative care typically required.
- Prior Diagnostic facet/MBB blocks documentation required (typically with ≥80% relief).
See the full Johns Hopkins HealthCare (Employer Health) criteria.
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