CPT 64635 · RFA · UnitedHealthcare (Commercial)
RFA — Lumbar/Sacral Facet (1st level) at UnitedHealthcare (Commercial).
How UnitedHealthcare (Commercial) approaches CPT 64635 (RFA — Lumbar/Sacral Facet (1st level)) for prior-authorization review: at last review on 2025-09-20, the policy covers this code with prior authorization required.
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UHC-MP-RFA-SPINECriteria summary
High-level themes from the UnitedHealthcare (Commercial) policy of record for CPT 64635. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
- Prior Diagnostic MBB (CPT 64493/64494) documentation required (typically with ≥80% relief).
Source: UnitedHealthcare Commercial Medical Policy — Radiofrequency Ablation of Spinal Facet Joints
See the full UnitedHealthcare (Commercial) criteria.
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