Does Humana require prior authorization for CPT 64490 in PA?

Q: Does Humana require prior authorization for CPT 64490 in PA?

Yes, Humana requires prior authorization for CPT 64490 (Site of service - Muscular/skeletal procedures (outpatient hospital/ASC only)) in PA. Documents needed: Clinical notes.

Humana Prior Authorization for CPT 64490

Site of service - Muscular/skeletal procedures (outpatient hospital/ASC only) in PA

Reviewed by D3rx Clinical Billing Team

Last updated: March 29, 2026

Prior Authorization Required

Documents Needed

Clinical notes

Clinical Criteria

Facet injections

Source: Humana Commercial Preauthorization and Notification List (July 2024)

Submission Tips

Document medical necessity thoroughly before submitting. Include clinical notes, relevant test results, and a clear rationale for why CPT 64490 is appropriate for the patient's condition.

About CPT 64490

CPT 64490 — Site of service - Muscular/skeletal procedures (outpatient hospital/ASC only). Prior authorization requirements vary by payer, plan type, and state. Humana requires prior authorization for this procedure in PA.

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CPT 64490 with Other Payers

UnitedHealthcare Aetna Cigna Anthem Blue Cross Blue Shield

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Medical Billing Disclaimer

The information provided on this page is for educational and informational purposes only. While we strive to maintain the most current and accurate prior authorization data, requirements change frequently and vary by individual plan type. Always verify prior authorization requirements directly with the payer before performing a procedure. D3rx is not responsible for any claim denials or reimbursement issues.