What documentation does Florida Blue Marketplace (HMO/HMO-POS) require for CPT 64483?

Member benefit and eligibility verification; Marketplace product-family verification; Clinical records supporting the requested service when requested by Florida Blue

How long does Florida Blue Marketplace (HMO/HMO-POS) take to respond to a PA request?

Standard Florida Blue Marketplace (HMO/HMO-POS) commercial PA determinations are returned within 5–14 business days for non-urgent requests and 72 hours for urgent (expedited) requests, per state-regulated and contractual timelines.

What if Florida Blue Marketplace (HMO/HMO-POS) denies the PA for CPT 64483?

Appeal in writing within 60 days, citing the specific clinical policy criteria the case meets and attaching supporting documentation. Many denials are reversed on first-level appeal when the criteria language is mirrored.

Prior Authorization

Florida Blue Marketplace (HMO/HMO-POS) Prior Authorization for CPT 64483

Epidural injection, lumbar/sacral · FL · commercial plans

Prior authorization REQUIREDVerified 2026-05-09 · Florida Blue

Source

Florida Blue Prior Authorization List: HMO - Marketplace Qualified Health Plans

Not medical advice. PA policies change frequently. Always confirm against the payer's current policy before submitting. d3rx pulls directly from publicly published policy PDFs and refreshes daily.

Clinical criteria

Florida Blue Marketplace HMO/HMO-POS prior authorization list includes 64483, version Mar 27 2026. This source applies to myBlue HMO and BlueCare HMO-POS Marketplace QHPs and covers medical items and services excluding drugs. Verify member benefits, Marketplace product family, provider participation, and current Florida Blue instructions before submission. This listing is not a payment, coverage, or medical-necessity approval guarantee.

Documentation checklist

✓Member benefit and eligibility verification
✓Marketplace product-family verification
✓Clinical records supporting the requested service when requested by Florida Blue

How to submit the PA

1Verify the requirement against the current clinical policy PDF linked above.
2Gather documentation: Member benefit and eligibility verification, Marketplace product-family verification, Clinical records supporting the requested service when requested by Florida Blue.
3Submit via the payer's provider portal or designated PA channel.
4Document the reference number and follow up within 5 business days if no determination is received.

FAQ

Does Florida Blue Marketplace (HMO/HMO-POS) require prior authorization for CPT 64483?: Yes. Florida Blue Marketplace (HMO/HMO-POS) requires prior authorization for CPT 64483 (Epidural injection, lumbar/sacral) under commercial plans in FL per its published clinical policy.
What documentation does Florida Blue Marketplace (HMO/HMO-POS) require for CPT 64483?: Member benefit and eligibility verification; Marketplace product-family verification; Clinical records supporting the requested service when requested by Florida Blue
How long does Florida Blue Marketplace (HMO/HMO-POS) take to respond to a PA request?: Standard Florida Blue Marketplace (HMO/HMO-POS) commercial PA determinations are returned within 5–14 business days for non-urgent requests and 72 hours for urgent (expedited) requests, per state-regulated and contractual timelines.
What if Florida Blue Marketplace (HMO/HMO-POS) denies the PA for CPT 64483?: Appeal in writing within 60 days, citing the specific clinical policy criteria the case meets and attaching supporting documentation. Many denials are reversed on first-level appeal when the criteria language is mirrored.

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