CPT 64635 · RFA · Florida Medicaid (FFS)
RFA — Lumbar/Sacral Facet (1st level) at Florida Medicaid (FFS).
How Florida Medicaid (FFS) approaches CPT 64635 (RFA — Lumbar/Sacral Facet (1st level)) for prior-authorization review: at last review on 2026-05-06, the policy covers this code without prior authorization.
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Coverage
Covered
Prior auth
No prior auth
Last reviewed
2026-05-06
Policy number
59G-4.222 / L33930Criteria summary
High-level themes from the Florida Medicaid (FFS) policy of record for CPT 64635. 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 Florida Medicaid (FFS) criteria.
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