CMM-201: Facet Joint Injections/Medial Branch Blocks

Covered: diagnostic and therapeutic facet joint injections/medial branch blocks (C2-3 to L5-S1) are medically necessary for facet-mediated axial neck/thoracic/lumbar pain (and intra‑articular injections with synovial cyst aspiration for radiculopathy when advanced imaging confirms nerve‑root compression), while ultrasound guidance, biologic or other non‑approved injectates, treatment of L5‑S1 for SIJ pain, and injections at posteriorly fused segments or using non‑approved techniques are excluded/considered experimental. Key requirements: pain ≥3 months with ≥4 weeks recent conservative care, clinical and imaging correlation excluding other causes, fluoroscopic or CT guidance, no more than two diagnostic blocks per level with a mandatory confirmatory second block showing ≥80% relief if radiofrequency ablation (RFA) is being considered, and therapeutic injections only if two positive diagnostic blocks exist and RFA is contraindicated, with specified limits on levels/session and timing of repeats.