CPT 95990 · Intrathecal Pump · Maryland Physicians Care (MPC)
Pain Pump — Refill (by clinician) at Maryland Physicians Care (MPC).
How Maryland Physicians Care (MPC) approaches CPT 95990 (Pain Pump — Refill (by clinician)) for prior-authorization review: at last review on 2026-04-26, the policy covers this code with prior authorization required.
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Clearway-MPG-PainPumpsCriteria summary
High-level themes from the Maryland Physicians Care (MPC) policy of record for CPT 95990. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 26 weeks of conservative care typically required.
- Prior Intrathecal trial via percutaneous catheter or single-shot bolus documentation required (typically with ≥50% relief).
Source: Clearway Master Payer Guidelines v2025 — Pain Pumps
See the full Maryland Physicians Care (MPC) criteria.
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