64418 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 64418

2 of 2 payer prior-auth lists that name 64418 require prior authorization or set conditions: UnitedHealthcare, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
UnitedHealthcareUnitedHealthcare Complete (Individual & Family plans)Allprior auth requiredSep 1, 2026Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of KentuckyKYprior auth requiredJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Kentucky Effective July 1, 2026

Payer coverage policies that name 64418

64418 appears in 14 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Capital Blue Cross, Centene.

PayerPolicyRole in policyReviewedDocument
AetnaComplex Regional Pain Syndrome (CRPS): Treatments (0447)listed, no stance (range 64400-64455)Jul 16, 2026payer document
AetnaDiabetic Neuropathy: Selected Treatments (0729)not coveredFeb 24, 2026payer document
AetnaHeadaches: Invasive Procedures (0707)not coveredJul 23, 2026payer document
AetnaInfusion Pumps (0161)covered if criteria are met (range 64400-64530)Mar 31, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 61000-64999)Jul 1, 2026payer document
AetnaNerve Blocks (0863)covered if criteria are metJul 23, 2026payer document
AetnaNerve Blocks (0863)covered if criteria are met (range 64400-64450)Jul 23, 2026payer document
AetnaNerve Blocks (0863)not coveredJul 23, 2026payer document
AetnaRespiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479)listed, no stance (range 61000-64999)Jul 9, 2026payer document
AetnaSpinal Ultrasound (0628)listed, no stance (range 64400-64530)Sep 11, 2026payer document
AetnaThermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703)listed, no stance (range 61000-64999)Nov 24, 2025payer document
AetnaUltrasound Guidance – Selected Indications (0952)not coveredApr 27, 2026payer document
Blue Cross & Blue Shield of MississippiPostoperative Pain Management (L.7.02.401)not coveredpayer document
Blue Cross NCInjection Therapy for Headache (Migraine and Other) and Non-Spine Managementlisted, no stanceOct 1, 2025payer document
Capital Blue CrossNeural Therapy (MP 8.012)
Procedure codes
unproven / investigationalFeb 1, 2026payer document
CenteneNerve Blocks and Neurolysis for Pain Management Reference Number: CP.MP.170 (CP.MP.170)covered if criteria are metFeb 1, 2025payer document

Recent prior-auth changes

  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Apr 1, 2026: PA removed, UnitedHealthcare Community Plan

Medicaid fee-for-service

  • AZ: $27.74 (asc), effective Oct 1, 2026
  • CO: $67.02 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $38.14 (physician, facility), effective Jan 1, 2026
  • IL: $47.15 (practitioner), effective Jul 1, 2026
  • IN: $42.87 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $203.40 (asc, facility), effective Aug 1, 1982
  • KY: $49.48 (asc), effective Jan 1, 2026
  • LA: $97.98 (professional), effective Feb 1, 2013
  • MA: $36.81 (asc), effective May 1, 2026
  • MS: $34.94 (comprehensive, facility), effective Oct 1, 2025
  • ND: $48.94 (physician, facility), effective Aug 1, 2026
  • NE: $62.12 (physician, facility), effective Jul 1, 2026
  • NY: $33.90 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $37.75 (physician, facility), effective Jan 1, 2024
  • OK: $43.40 (physician, facility), effective Jul 1, 2026
  • TX: $38.76 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $41.67 (medical, facility), effective Jul 1, 2026
  • VT: $548.09 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $28.09 (physician, facility), effective Jul 1, 2026
  • WY: $312.17 (outpatient_hospital_apc, Ambulatory Surgical Centers), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.