Medicaid: New facet injection codes for prior authorization in select states

Effective Nov. 1, 2021, we’re adding 6 new facet injection procedure-related CPT® codes (64490‒64495) to the prior authorization list for UnitedHealthcare Community Plan members in the following states:

  • Arizona
  • California
  • Maryland
  • Mississippi
  • Missouri
  • New Jersey
  • Wisconsin

For complete details on facet injection protocol, please see the Community Plan Medical & Drug Policies and Coverage Determination Guidelines.

To submit prior authorizations online:

  1. Go to and click Sign In to access the UnitedHealthcare Provider Portal
  2. Select Prior Authorizations from the blue navigation bar at the top of the page
  3. Click Create New Submissions (located in the create a new notification or prior authorization request box)

Training available

Check out the following to help you manage prior authorizations online:


Please contact your local Network Management representative or call UnitedHealthcare Provider Services, toll-free, at 877-842-3210, 7 a.m.–5 p.m. CT, Monday–Friday.

CPT® is a registered trademark of the American Medical Association.