CPT 95991 · Pump Maintenance · Illinois Medicaid (HFS)
Pain Pump — Refill w/ Reprogramming at Illinois Medicaid (HFS).
How Illinois Medicaid (HFS) approaches CPT 95991 (Pain Pump — Refill w/ Reprogramming) for prior-authorization review: at last review on 2025-11-01, the policy covers this code without prior authorization.
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Coverage
Covered
Prior auth
No prior auth
Last reviewed
2025-11-01
Criteria summary
High-level themes from the Illinois Medicaid (HFS) policy of record for CPT 95991. Verbatim policy text and per-criterion analysis are available after sign-in.
- Prior diagnostic procedure documentation required.
Source: Illinois Medicaid (HFS) Drug Infusion Pump Maintenance
See the full Illinois Medicaid (HFS) criteria.
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