Payor
Regence BlueShield
Rubrica tracks 59 sourced coverage rules across 59 CPT codes for Regence BlueShield — covering interventional spine, pain management, ortho spine, and orthopedics. Plan type(s): commercial. 4-state regional policy (sample: id, or, ut, wa).
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Every Rubrica record cites a specific Regence BlueShield policy document with last-reviewed date and (where available) verbatim source text. Aggregate coverage breakdown by procedure category is shown below; full payor-specific criteria require sign-in.
Coverage by category
Regence BlueShield's coverage stance across procedure categories tracked in the Rubrica catalog.
| Category | Rules | Covered | Prior auth | Investigational |
|---|---|---|---|---|
| Other Procedure | 8 | 8 | 7 | 0 |
| Epidural | 6 | 6 | 6 | 0 |
| Facet/MBB | 6 | 6 | 6 | 0 |
| Spine Surgery | 5 | 5 | 5 | 0 |
| RFA | 4 | 4 | 4 | 0 |
| ViaDisc | 4 | 0 | 4 | 4 |
| Arthroplasty — Knee | 3 | 3 | 3 | 0 |
| Vertebral Augmentation | 3 | 3 | 3 | 0 |
| Arthroplasty — Hip | 2 | 2 | 2 | 0 |
| Arthroscopy — Knee | 2 | 2 | 2 | 0 |
| BVN ablation | 2 | 0 | 2 | 2 |
| Decompression | 2 | 1 | 2 | 1 |
Top tracked procedures
First 15 CPT codes in the Regence BlueShield catalog. Sign in for verbatim criteria, source links, and the rest of the catalog.
| CPT | Procedure | Coverage |
|---|---|---|
62321 | Interlaminar ESI — Cervical/Thoracic | Covered |
62323 | Interlaminar ESI — Lumbar | Covered |
64479 | Transforaminal ESI — Cervical/Thoracic 1st level | Covered |
64480 | Transforaminal ESI — Cervical/Thoracic add'l | Covered |
64483 | Transforaminal ESI — Lumbar/Sacral 1st level | Covered |
64484 | Transforaminal ESI — Lumbar/Sacral add'l | Covered |
64490 | Cervical/Thoracic facet/MBB — 1st level | Covered |
64491 | Cervical/Thoracic facet/MBB — 2nd level | Covered |
64492 | Cervical/Thoracic facet/MBB — 3rd level | Covered |
64493 | Lumbar/Sacral facet/MBB — 1st level | Covered |
64494 | Lumbar/Sacral facet/MBB — 2nd level | Covered |
64495 | Lumbar/Sacral facet/MBB — 3rd level | Covered |
64633 | RFA — Cervical/Thoracic 1st level | Covered |
64634 | RFA — Cervical/Thoracic add'l | Covered |
64635 | RFA — Lumbar/Sacral 1st level | Covered |
64636 | RFA — Lumbar/Sacral add'l | Covered |
27096 | Sacroiliac joint injection | Covered |
G0260 | SI joint injection (ASC facility code) | Covered |
27279 | Sacroiliac joint fusion (minimally invasive) | Covered |
63650 | SCS — Percutaneous Trial | Covered |
63685 | SCS — Permanent Pulse Generator Implant | Covered |
22513 | Vertebral augmentation — thoracic | Covered |
22514 | Vertebral augmentation — lumbar | Covered |
22515 | Vertebral augmentation — add'l level | Covered |
62330 | MILD — Cervical/thoracic minimally invasive lumbar decompression | Not covered |
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