64421 CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 64421 require prior authorization or set conditions: UnitedHealthcare Community Plan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| UnitedHealthcare Community Plan | UnitedHealthcare Community Plan of Kentucky | KY | prior auth required | Jul 1, 2026 | Prior authorization requirements for UnitedHealthcare Community Plan of Kentucky Effective July 1, 2026 |
64421 appears in 15 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Centene.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Back Pain - Invasive Procedures (0016) | not covered | Oct 6, 2026 | payer document |
| Aetna | Bupivacaine Liposome (Exparel) (0941) | listed, no stance (range 64420-64421) | Jul 30, 2026 | payer document |
| Aetna | Complex Regional Pain Syndrome (CRPS): Treatments (0447) | listed, no stance (range 64400-64455) | Jul 16, 2026 | payer document |
| Aetna | Cryoanalgesia and Therapeutic Cold (0297) | listed, no stance | Apr 14, 2026 | payer document |
| Aetna | Infusion Pumps (0161) | covered if criteria are met (range 64400-64530) | Mar 31, 2026 | payer document |
| Aetna | Intravenous Iron Therapy (0575) | listed, no stance (range 61000-64999) | Jul 1, 2026 | payer document |
| Aetna | Nerve Blocks (0863) | covered if criteria are met (range 64420-64421) | Jul 23, 2026 | payer document |
| Aetna | Nerve Blocks (0863) | covered if criteria are met (range 64400-64450) | Jul 23, 2026 | payer document |
| Aetna | Post-Herpetic Neuralgia (0725) | not covered | Oct 20, 2025 | payer document |
| Aetna | Respiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479) | listed, no stance (range 61000-64999) | Jul 9, 2026 | payer document |
| Aetna | Spinal Ultrasound (0628) | listed, no stance (range 64400-64530) | Sep 11, 2026 | payer document |
| Aetna | Thermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703) | listed, no stance (range 61000-64999) | Nov 24, 2025 | payer document |
| Aetna | Ultrasound Guidance – Selected Indications (0952) | covered if criteria are met | Apr 27, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Postoperative Pain Management (L.7.02.401) | not covered | payer document | |
| Blue Cross NC | Injection Therapy for Headache (Migraine and Other) and Non-Spine Management | listed, no stance | Oct 1, 2025 | payer document |
| Centene | Nerve Blocks and Neurolysis for Pain Management Reference Number: CP.MP.170 (CP.MP.170) | covered if criteria are met | Feb 1, 2025 | payer document |
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.