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CPT 95971 · SCS · Health Partners Plans / Jefferson Health Plans — PA HealthChoices

SCS — Simple Programming at Health Partners Plans / Jefferson Health Plans — PA HealthChoices.

How Health Partners Plans / Jefferson Health Plans — PA HealthChoices approaches CPT 95971 (SCS — Simple Programming) 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 numberCMM-211

Criteria summary

High-level themes from the Health Partners Plans / Jefferson Health Plans — PA HealthChoices policy of record for CPT 95971. Verbatim policy text and per-criterion analysis are available after sign-in.

Coverage criteria details available after sign-in.

Source: eviCore by Evernorth — CMM-211 Spinal Cord and DRG Stimulators (HPP/Jefferson MSK Pain Management Program)

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