CPT G0260 · SI Joint · BCBS Federal Employee Program
SI Joint Injection (Medicare ASC HCPCS) at BCBS Federal Employee Program.
How BCBS Federal Employee Program approaches CPT G0260 (SI Joint Injection (Medicare ASC HCPCS)) for prior-authorization review: at last review on 2026-04-27, the policy covers this code without prior authorization.
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BCBSA EPS 6.01.23 / FEP reference policyCriteria summary
High-level themes from the BCBS Federal Employee Program policy of record for CPT G0260. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: FEP 6.01.23 (BCBSA EPS reference) — Diagnosis and Treatment of Sacroiliac Joint Pain
See the full BCBS Federal Employee Program criteria.
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