CPT 64635 · RFA · Medicare (National NCDs)
RFA — Lumbar/Sacral Facet (1st level) at Medicare (National NCDs).
How Medicare (National NCDs) approaches CPT 64635 (RFA — Lumbar/Sacral Facet (1st level)) for prior-authorization review: at last review on 2025-10-01, the policy covers this code without prior authorization.
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Coverage
Covered
Prior auth
No prior auth
Last reviewed
2025-10-01
Criteria summary
High-level themes from the Medicare (National NCDs) policy of record for CPT 64635. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Imaging concordance documentation required.
- Prior Two diagnostic medial branch blocks (CPT 64493/64494) documentation required (typically with ≥80% relief).
See the full Medicare (National NCDs) criteria.
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