CPT 95990 · Intrathecal Pump · Liberty Mutual / Helmsman WC
Pain Pump — Refill (by clinician) at Liberty Mutual / Helmsman WC.
How Liberty Mutual / Helmsman WC approaches CPT 95990 (Pain Pump — Refill (by clinician)) for prior-authorization review: at last review on 2026-05-09, the policy covers this code with prior authorization required.
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Criteria summary
High-level themes from the Liberty Mutual / Helmsman WC policy of record for CPT 95990. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: Liberty Mutual / Helmsman WC Workers' Compensation Medical Treatment Guidelines
See the full Liberty Mutual / Helmsman WC criteria.
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