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Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for New Jersey Only)
Effective date
Jan 1, 2027
Identified
Nov 7, 2026
Summary
UnitedHealthcare Community Plan of New Jersey's November 2026 medical policy bulletin updates the Occipital Nerve Injections and Ablation policy for New Jersey Medicaid members: CPT codes 1057T, 1058T, 1059T, 1060T and 1061T are added, and CPT 64570 is removed. The bulletin notes that the newly added codes are not on the State of New Jersey Medicaid Fee Schedule and therefore may not be covered by the New Jersey Medicaid Program. The billing team should verify coverage status before scheduling or billing these services for affected members.
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What to do
Action · 3 steps
01By 2027-01-01: Billing team should check the New Jersey Medicaid fee schedule before scheduling occipital nerve injection or ablation services using CPT 1057T, 1058T, 1059T, 1060T or 1061T for UnitedHealthcare Community Plan of New Jersey Medicaid members, since these codes may not be covered.
02Update charge entry and the scheduling or procedure code lists so CPT 64570 is no longer selected for these members from that date.
03Providers and front desk staff should be told which codes are affected and that coverage for the new codes is uncertain, and discuss alternatives or patient financial notice with the patient where the payer allows it.
Codes mentioned
64570
Original notice
Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) (for New Jersey Only)
uhcprovider.com · Always check the source before changing claims.
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