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Johns Hopkins Health Plans

Authorization Changes Effective Sept. 21 for USFHP Providers

Effective Date: Sept. 21, 2026

Health Plans Affected: US Family Health Plan (USFHP)

Type of Change: Authorization Requirements Status

Explanation of Change:

Authorization status code changes have been confirmed for USFHP, which go into effect Sept. 21, 2026. These requirements affect members of all ages enrolled in the plan.

Key: PA=Prior Authorization Required; NPA=No Prior Authorization Required

USFHP Code Changes

  • 64490 - Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed); NPA
  • 64491 - Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level (List separately in addition to code for primary procedure); NPA
  • 64493 - Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level; NPA
  • 64494 - Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure); NPA
  • 64495 - Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (List separately in addition to code for primary procedure); NPA
  • 74176 - Computed tomography, abdomen and pelvis w/o contrast; NPA
  • 74177 - Computed tomography, abdomen and pelvis without contrast; NPA
  • 74178 - Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions; NPA
  • 97161 - Physical therapy evaluation, low complex, 20 mins; NPA
  • 97165 - Occupational therapy evaluation, low complex, 30 mins; NPA