Policy library / 0164T Commercial payer policies listing 0164T 6 policies from 5 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Carelon Medical Benefits Management policies listing 0164T, with the code’s status in each Policy Effective Status of 0164T Spine Surgery Clinical Guideline · CARELON-SPINE-SURGERY Sep 19, 2026 Covered Spine Surgery [for Wellpoint Massachusetts] Clinical Guideline · CARELON-SPINE-SURGERY-SUPERSEDED Nov 15, 2025 Covered
BCBS Illinois policies listing 0164T, with the code’s status in each Policy Effective Status of 0164T Artificial Intervertebral Disc PayerPolicy · BCBSIL-SUR712.028 Jan 1, 2026 Covered
BCBS Montana policies listing 0164T, with the code’s status in each Policy Effective Status of 0164T Artificial Intervertebral Disc PayerPolicy · BCBSMT-SUR712.028 Jan 1, 2026 Covered
BCBS New Mexico policies listing 0164T, with the code’s status in each Policy Effective Status of 0164T Artificial Intervertebral Disc PayerPolicy · BCBSNM-SUR712.028 Jan 1, 2026 Covered
BCBS Oklahoma policies listing 0164T, with the code’s status in each Policy Effective Status of 0164T Artificial Intervertebral Disc PayerPolicy · BCBSOK-SUR712.028 Jan 1, 2026 Covered