Aetna Pain Management Procedures prior authorization requirements (2026)
What Aetna generally requires to approve Pain Management Procedures (CPT 27096, 62320, 62321, 62322, 62323, 62324, 62325, 62326, 62327, 64479, 64480, 64483, 64484, 64490, 64491, 64492, 64493, 64494, 64495, 64510, 64520, 64633, 64634, 64635, 64636, 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 0627T, 0628T, 0629T, 0630T, G0259, G0260), for Commercial plans. Yes. Aetna generally requires prior authorization for Pain Management Procedures (CPT 27096, 62320, 62321, 62322, 62323, 62324, 62325, 62326, 62327, 64479, 64480, 64483, 64484, 64490, 64491, 64492, 64493, 64494, 64495, 64510, 64520, 64633, 64634, 64635, 64636, 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 0627T, 0628T, 0629T, 0630T, G0259, G0260).
Medical-necessity criteria Aetna generally applies
Medical necessity review through EviCore healthcare
Commonly required documentation
- All medical records
- submit via EviCore portal or fax
How to submit
- Method: portal
- Typical turnaround: about 3 days
Source
Contact EviCore at 1-888-622-7329; fax 1-855-774-1319; Not required for Student Health and Allina Health | Aetna plans Last verified 2026-05-06.
Frequently asked questions
Does Aetna require prior authorization for Pain Management Procedures?
Yes. Aetna generally requires prior authorization for Pain Management Procedures (CPT 27096, 62320, 62321, 62322, 62323, 62324, 62325, 62326, 62327, 64479, 64480, 64483, 64484, 64490, 64491, 64492, 64493, 64494, 64495, 64510, 64520, 64633, 64634, 64635, 64636, 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 0627T, 0628T, 0629T, 0630T, G0259, G0260).
What does Aetna require to approve Pain Management Procedures?
Medical necessity review through EviCore healthcare Always confirm against the current Aetna policy.
How long does a Aetna prior authorization take?
Aetna typically decides Pain Management Procedures requests in about 3 days. Timeframes vary; check the payer portal.
Submitting Pain Management Procedures to Aetna?
Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.