Medicare AdvantageCoverageMedium impact
Diagnosis and Treatment of Sacroiliac Joint Pain
Blue Cross Blue Shield of Rhode Island·RI · Pain Management, Orthopedics, PM&R (Physical Medicine & Rehab) +1 more·Physician / Facility
Effective date
Jul 1, 2022
We identified it
Jun 19, 2026
Summary
Effective July 1, 2022, CPT code 64625 (radiofrequency ablation of nerves innervating the sacroiliac joint) is no longer covered for Medicare Advantage plans and is not considered medically necessary for commercial products. This means claims for this procedure will likely be denied for both plan types.
Action Required
Immediately: Stop billing CPT 64625 for radiofrequency ablation of sacroiliac joint nerves for Medicare Advantage and commercial plans. Billing team must update system to flag this code as non-covered. Providers should be notified that this procedure is no longer reimbursable and alternative treatments should be considered. Claims submitted will be denied.