CPT 64633 · RFA · Sunshine Health (Centene) — Florida Medicaid
RFA — Cervical/Thoracic Facet (1st level) at Sunshine Health (Centene) — Florida Medicaid.
How Sunshine Health (Centene) — Florida Medicaid approaches CPT 64633 (RFA — Cervical/Thoracic Facet (1st level)) for prior-authorization review: at last review on 2026-05-06, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-06
Policy number
CP.MP.171 / 59G-4.222 / L33930Criteria summary
High-level themes from the Sunshine Health (Centene) — Florida Medicaid policy of record for CPT 64633. Verbatim policy text and per-criterion analysis are available after sign-in.
- Conservative care expectations vary; sign in for specifics.
- Imaging concordance documentation required.
- Prior Diagnostic temporary block (medial branch block / facet block) under fluoroscopic guidance documentation required (typically with ≥50% relief).
See the full Sunshine Health (Centene) — Florida Medicaid criteria.
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