Removal of Facet HCPCS Codes

Prior Authorization Outpatient Department Update 

Effective 8/16/2024, the CMS is removing two current procedural terminology codes from the OPD Facet Joint Injection list of codes:

• 64492 – Facet joint injection(s), diagnostic or therapeutic, cervical or thoracic; third and any additional level(s)
• 64495 – Facet joint injection(s), diagnostic or therapeutic, lumbar; third and any additional level(s) from the list of codes that require prior authorization as a condition of payment. 

Prior authorization will no longer be required for these codes for claims with dates of service on or after 8/16/2024. 

Please refer to the below list of codes that require prior authorization updated by CMS, as well as the updated OPD Operational Guide. 

Related Content

• Revised list of HCPCS codes that require prior authorization
• Revised PA program for certain hospital OPD guide

Posted 8/8/2024