64597 CPT® code: payer coverage and prior authorization18 of 18 payer prior-auth lists that name 64597 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), CarePlus Health Plans, Cigna, Humana.
64597 appears in 41 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Centene, Cigna, Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Epilepsy Surgery (0394) | covered if criteria are met | Jun 23, 2026 | payer document |
| Aetna | Intraoperative Neurophysiological Monitoring (0697) | not covered (range 64596-64598) | Jun 19, 2026 | payer document |
| Aetna | Intravenous Iron Therapy (0575) | listed, no stance (range 61000-64999) | Jul 1, 2026 | payer document |
| Aetna | Peripheral Electrical Nerve Stimulation for Pain (0011) | covered if criteria are met | Jun 3, 2026 | 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 | Thermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703) | listed, no stance (range 61000-64999) | Nov 24, 2025 | payer document |
| Anthem | Implantable Peripheral Nerve Stimulation Devices as a Treatment for Pain (SURG.00158) | unproven / investigational | Nov 6, 2025 | payer document |
| Blue Cross & Blue Shield of Mississippi | Implantable Peripheral Nerve Stimulation For Chronic Pain Conditions | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Sacral Nerve Neuromodulationstimulation | covered if criteria are met | payer document | |
| Blue Cross NC | Neurostimulation, Electrical | listed, no stance | Apr 1, 2026 | payer document |
| Blue Cross NC | Percutaneous Electrical Nerve Stimulation (PENS), Percutaneous Neuromodulation Therapy, Restorative Neurostimulation Therapy, and Percutaneous Electrical Nerve Field Stimulation (PENFS) | listed, no stance | Jun 1, 2026 | payer document |
| Centene | Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation (CP.MP.117) | covered if criteria are met | Nov 1, 2025 | payer document |
| Cigna | Peripheral Nerve Stimulation and Peripheral Nerve Field Stimulation (0539) | not covered | Mar 15, 2026 | payer document |
| Premera Blue Cross | Implantable Peripheral Nerve Stimulation for the Treatment of Chronic Pain and Other Conditions (7.01.574) Page | 2 of 18 | ∞ | listed, no stance | Jul 1, 2026 | payer document |
| Regence | Implantable Peripheral Nerve Stimulation and Peripheral Subcutaneous Field Stimulation (Surgery 205) | listed, no stance | Jul 1, 2026 | payer document |
| Regence | Occipital Nerve Stimulation (Surgery 174) | listed, no stance | Apr 1, 2026 | payer document |
| Regence | Sacral Nerve Neuromodulation (Stimulation) for Pelvic Floor Dysfunction (Surgery 134) | listed, no stance | Oct 1, 2025 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (CS036.Y) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (2026T0126UU) | listed, no stance | Mar 1, 2026 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Idaho Only) (CS036ID.D) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Kansas Only) (CS036KS.02) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Kentucky Only) (CS036KY.12) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Nebraska Only) (CS036NE.U) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for New Jersey Only) (CS036NJ.T) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for New Mexico Only) (CS036NM.D) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Ohio Only) (CS036OH.F) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Pennsylvania Only) (CS036PA.W) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Tennessee Only) (CS036TN.Y) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (2026T0080TT) | listed, no stance | Sep 10, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (CS086.AC) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Idaho Only) (CS086ID.B) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Kansas Only) (CS086KS.03) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Kentucky Only) (CS086KY.13) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Louisiana Only) (CS086LA.W) | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Nebraska Only) (CS086NE.AC) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for New Jersey Only) (CS086NJ.Y) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for New Mexico Only) (CS086NM.D) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for North Carolina Only) (CSNCT0080.06) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Ohio Only) (CS086OH.E) | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Pennsylvania Only) (CS086PA.Z) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Tennessee Only) (CS086TN.AA) | listed, no stance | Sep 1, 2026 | payer document |
Prior authorization required or conditional in VA.
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.