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PAYER POLICY CHANGES

64473 Insurance Policy Changes

CPT 64473, in plain terms, covers Unilateral lower extremity fascial plane nerve block, such as at the hip or knee, by one or more injections. CPT 64473 is referenced in 3 tracked payer policy changes from Sentara Health Plans, Aetna, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 64473 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 64473 on AAPC

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REFERENCE DATA

Payers with rules5
Payers requiring prior auth5
  • Fidelis Care · Effective November 1, 2026

    Prior authorization required in some cases

    Fidelis Care Metal-Level Products authorization grid

  • Ambetter · Effective December 31, 2025

    Prior authorization required

    Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements

  • Arizona Complete Health · Effective December 31, 2025

    Prior authorization required

    Arizona Complete Health CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for 64473?

Ambetter lists 64473 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for 64473?

Arizona Complete Health lists 64473 on Arizona Complete Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Centene require prior authorization for 64473?

Centene lists 64473 on Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Coordinated Care require prior authorization for 64473?

Coordinated Care lists 64473 on Coordinated Care CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Fidelis Care require prior authorization for 64473?

Fidelis Care lists 64473 on Fidelis Care Metal-Level Products authorization grid for exchange plans, with conditions (list dated November 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 64473?

There are 3 tracked policy changes affecting CPT 64473, including updates from Sentara Health Plans, Aetna, Blue Cross and Blue Shield of Louisiana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 64473?

Payers that have issued tracked updates for CPT 64473 include: Sentara Health Plans, Aetna, Blue Cross and Blue Shield of Louisiana.

How do I get notified when CPT 64473 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 64473. 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 64473?

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 64473

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 64473 in one place.

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