64744 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 64744

6 of 6 payer prior-auth lists that name 64744 require prior authorization or set conditions: UnitedHealthcare, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
UnitedHealthcarePreferred Care Network and Preferred Care Partners of FloridaFLprior auth requiredOct 1, 2026Prior authorization requirements for Preferred Care Network and Preferred Care Partners of Florida Effective October 1, 2026
UnitedHealthcareUnitedHealthcare Medicare Advantage, Peoples Health and Dual Complete (D-SNP)Allprior auth requiredOct 1, 2026UnitedHealthcare® Medicare Advantage/ Peoples Health Plans prior authorization requirements Effective October 1, 2026
UnitedHealthcare Community PlanMassachusetts OneCareMAprior auth requiredNov 1, 2025Prior authorization requirements for Massachusetts OneCare Effective November 1, 2025
UnitedHealthcare Community PlanMassachusetts Senior Care Options (SCO)MAprior auth requiredNov 1, 2025CPT® is a registered trademark of the American Medical Association. Prior authorization requirements for Massachusetts Senior Care Options Effective November 1, 2025
UnitedHealthcare Community PlanMassachusetts Senior Care Options (SCO) and OneCareMAprior auth requiredOct 1, 2026Prior authorization requirements for Massachusetts MA SCO OneCare Effective October 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Connected (Texas MMP)TXprior auth requiredJan 1, 2015Prior authorization requirements for UnitedHealthcare Connected (Medicare-Medicaid Plan) Texas Effective November 1, 2025 This list contains prior authorization review requirements for participating U

Payer coverage policies that name 64744

64744 appears in 19 coverage policies from Aetna, Anthem, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaHeadaches: Invasive Procedures (0707)not coveredJul 23, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 61000-64999)Jul 1, 2026payer document
AetnaRespiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479)listed, no stance (range 61000-64999)Jul 9, 2026payer document
AetnaThermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703)listed, no stance (range 61000-64999)Nov 24, 2025payer document
AnthemSurgical and Ablative Treatments for Chronic Headaches (SURG.00096)unproven / investigationalFeb 19, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (CS086.AC)listed, no stanceSep 1, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (2026T0080TT)listed, no stanceSep 10, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Idaho Only) (CS086ID.B)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Kansas Only) (CS086KS.03)listed, no stanceSep 1, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Kentucky Only) (CS086KY.13)listed, no stanceSep 1, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Louisiana Only) (CS086LA.W)listed, no stanceNov 1, 2025payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Nebraska Only) (CS086NE.AC)listed, no stanceSep 1, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for New Jersey Only) (CS086NJ.Y)listed, no stanceSep 1, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for New Mexico Only) (CS086NM.D)listed, no stanceSep 1, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for North Carolina Only) (CSNCT0080.06)listed, no stanceSep 1, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Ohio Only) (CS086OH.E)listed, no stanceDec 1, 2025payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Pennsylvania Only) (CS086PA.Z)listed, no stanceSep 1, 2026payer document
UnitedHealthcareOccipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for Tennessee Only) (CS086TN.AA)listed, no stanceSep 1, 2026payer document
UnitedHealthcarePain Management (MMP070.12)
Decompression and Transection or Avulsion of Greater Occipital Nerve for Treatment of Headaches
listed, no stanceSep 1, 2026payer document

Recent prior-auth changes

  • Oct 1, 2026: PA removed, Oxford Health Plans

Medicaid fee-for-service

  • AZ: $556.61 (asc), effective Oct 1, 2026
  • CO: $261.89 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $421.61 (physician, non-facility), effective Jan 1, 2026
  • IL: $517.84 (practitioner), effective Apr 1, 2024
  • IN: $381.39 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $248.72 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $926.03 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $677.27 (asc), effective May 1, 2026
  • MS: $739.94 (comprehensive, facility), effective Oct 1, 2025
  • ND: $545.90 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $199.86 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $311.29 (physician), effective Jan 1, 2024
  • OK: $844.84 (asc), effective Jan 1, 2026
  • TX: $659.94 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $469.62 (medical), effective Jul 1, 2026
  • VT: $1516.22 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $863.57 (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.