CPT 95990 · Intrathecal Pump · Wellpoint Maryland
Pain Pump — Refill (by clinician) at Wellpoint Maryland.
How Wellpoint Maryland approaches CPT 95990 (Pain Pump — Refill (by clinician)) for prior-authorization review: at last review on 2026-04-27, the policy covers this code without prior authorization.
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Carelon IPM (MSK01) / Anthem CG-SURG-15 (related)Criteria summary
High-level themes from the Wellpoint Maryland 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: Anthem Medical Policy / Carelon IPM — Intrathecal Drug Delivery (Pain & Spasticity)
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