Facet Joint Injections | BCBS Montana | Backwork

Facet Joint Injections

BCBS Montana · PayerPolicy · BCBSMT-SUR702.015

Status: Active
Effective: January 1, 2026
Last checked by Backwork: October 1, 2026

Summary of the payer’s published policy. Not a coverage determination — confirm with BCBS Montana before submitting.

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Codes in this policy

Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
0213T	CPT	Covered
0214T	CPT	Covered
0215T	CPT	Covered
0216T	CPT	Covered
0217T	CPT	Covered
0218T	CPT	Covered
64490	CPT	Covered
64491	CPT	Covered
64492	CPT	Covered
64493	CPT	Covered
64494	CPT	Covered
64495	CPT	Covered
77003	CPT	Covered