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PAYER POLICY CHANGES

61790 Insurance Policy Changes

CPT 61790, in plain terms, covers Percutaneous stereotactic lesion of the gasserian ganglion using a neurolytic agent such as alcohol, thermal, electrical, or radiofrequency energy. CPT 61790 is referenced in 1 tracked payer policy change from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 61790 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 61790 on AAPC

Watch 61790

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REFERENCE DATA

Payers with rules2
Payers requiring prior auth2
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • Fidelis Care · Effective December 31, 2025

    Prior authorization required

    Fidelis Care CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for 61790?

Anthem BCBS lists 61790 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does Fidelis Care require prior authorization for 61790?

Fidelis Care lists 61790 on Fidelis Care CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

What insurance policy changes affect CPT 61790?

There are 1 tracked policy change affecting CPT 61790, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 61790?

Payers that have issued tracked updates for CPT 61790 include: Aetna.

How do I get notified when CPT 61790 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 61790. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 61790?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for 61790

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 61790 in one place.

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