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).

General reference compiled from public sources, last verified 2026-05-06. This is not a coverage determination or medical advice. Always confirm current requirements with Aetna before submitting.

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.

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Other Aetna prior authorization requirements

ACL ReconstructionAnterior Cervical Discectomy and FusionArthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairArtificial Intervertebral Disc Surgery (Cervical Spine)Artificial Intervertebral Disc Surgery (Lumbar Spine)Autologous Chondrocyte ImplantationBunionectomy (Hallux Valgus Correction)Cervical, Lumbar and Thoracic Laminectomy and/or Laminotomy ProceduresChiari Malformation Decompression SurgeryCochlear Device and/or ImplantationCT Abdomen and Pelvis with contrastCTA Chest (e.g., pulmonary embolism)

Related guides

Why was my prior authorization denied? Top reasons and how to fix eachHow to write a prior authorization appeal that cites policy