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PAYER POLICY CHANGES

64605 Insurance Policy Changes

CPT 64605, in plain terms, covers Chemical destruction with a neurolytic agent of the second and third division branches of the trigeminal nerve at the foramen ovale. CPT 64605 is referenced in 2 tracked payer policy changes from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 64605 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 64605 on AAPC

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REFERENCE DATA

Payers with rules4
Payers requiring prior auth4
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

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

  • Fidelis Care · Effective November 1, 2026

    Prior authorization required in some cases

    Fidelis Care Metal-Level Products authorization grid

  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for 64605?

Anthem BCBS lists 64605 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 CalViva Health require prior authorization for 64605?

CalViva Health lists 64605 on CalViva Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for 64605?

Community Health Plan of Imperial Valley lists 64605 on Community Health Plan of Imperial Valley 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 64605?

Fidelis Care lists 64605 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 64605?

There are 2 tracked policy changes affecting CPT 64605, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 64605?

Payers that have issued tracked updates for CPT 64605 include: Aetna.

How do I get notified when CPT 64605 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 64605. 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 64605?

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 64605

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 64605 in one place.

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